Organization
SAN JUAN REGIONAL MEDICAL CENTER INC
Active
Other names
SAN JUAN REGIONAL CARDIOLOGY, San Juan Regional Heart Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BYRD (ADMINISTRATIVE DIRECTOR OF REIMBURS)
(505) 609-2258
Entity
Organization
Contact information
Practice address
407 S SCHWARTZ AVE, SUITE 202, FARMINGTON, NM 87401
(505) 609-6770
(505) 609-6775
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39608514
—
CO
05
—
97172766
—
NM
Enumeration date
05/18/2007
Last updated
07/16/2025
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