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Individual

EDUARDO BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
224 ANTHONY DR STE B, ANTHONY, NM 88021-9190
(360) 360-8539
Mailing address
224 ANTHONY DR STE B, ANTHONY, NM 88021-9190
(360) 360-8539

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
374U00000X
Home Health Aide

Other

Enumeration date
05/13/2025
Last updated
05/13/2025
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