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Organization
BRAZOS VALLEY CARDIO RESPIRATORY
Active
Organization
BRAZOS VALLEY CARDIO RESPIRATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN E MILLER RRT/RCP (OWNER)
(575) 257-5083
Entity
Organization
Contact information
Practice address
141-A MESCALERO TR., RUIDOSO, NM 88345
(575) 257-5083
(575) 257-5083
Mailing address
141-A MESCALERO TR., RUIDOSO, NM 88345
(575) 257-5083
(575) 257-5083
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
56124
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0059159
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111049-01
—
TX
Enumeration date
12/24/2007
Last updated
04/09/2009
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