Individual
HECTOR ANIBAL PONCE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP
Contact information
Practice address
3900 E LOHMAN AVE STE B, LAS CRUCES, NM 88011-8268
(575) 522-5752
(575) 522-5722
Mailing address
12848 TIERRA PUEBLO, EL PASO, TX 79938-4303
(915) 217-6585
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
77261
NM
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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