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Organization
SANTA TERESA MEDICAL CARE CENTER PC
Active
Organization
SANTA TERESA MEDICAL CARE CENTER PC
Active
Other names
Santa Teresa Medical Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAURENCE JUAREZ (ADMINISTRATOR)
(915) 842-0504
Entity
Organization
Contact information
Practice address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(575) 589-5005
(575) 589-1333
Mailing address
5055 MCNUTT RD, PO BOX 5, SANTA TERESA, NM 88008-9442
(575) 589-5005
(575) 589-1333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0733024-01
—
TX
05
—
49189
—
NM
01
—
CS9566
PALMETTO GBA
NM
Enumeration date
12/28/2005
Last updated
07/30/2013
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