Organization
CORRALES FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALYSON P THAL M.D. (OWNER)
(505) 792-3065
Entity
Organization
Contact information
Practice address
3841 CORRALES RD, CORRALES, NM 87048-9311
(505) 792-3065
(505) 792-4004
Mailing address
3841 CORRALES RD, CORRALES, NM 87048-9311
(505) 792-3065
(505) 792-4004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86346
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34224801
—
NM
Enumeration date
08/08/2007
Last updated
06/12/2008
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