Organization
ANGEL FIRE PRIMARY CARE
Active
Other names
Red River Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESA D FRAKER MD (PRESIDENT)
(505) 989-8707
Entity
Organization
Contact information
Practice address
200 A PIONEER ROAD, RED RIVER, NM 87558-0000
(575) 754-1773
(505) 989-3536
Mailing address
707 PASEO DE PERALTA, SANTA FE, NM 87501-1922
(505) 989-8707
(505) 989-3536
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/01/2012
Last updated
06/01/2012
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