# SOUTHWEST HEART PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265502298
- **Authorized official:** DR. TERRY A BOULWARE M.D. (OWNER)
- **Authorized official phone:** (505) 522-7247

## Contact information

- **Practice address:** 4351 E LOHMAN AVE STE 405, LAS CRUCES, NM 88011-8261
- **Practice address phone:** (575) 522-2233
- **Practice address fax:** (575) 522-2266
- **Mailing address:** 4351 E LOHMAN AVE STE 405, LAS CRUCES, NM 88011-8261
- **Mailing address phone:** (575) 522-2233
- **Mailing address fax:** (575) 522-2266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | NULL | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 01/22/2020