Organization
MIMBRES INTERNAL MEDICINE PA
Active
Organization
MIMBRES INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM AL-HOMSI M.D. (OWNER)
(575) 544-7280
Entity
Organization
Contact information
Practice address
122 S GOLD AVE, SUITE 3, DEMING, NM 88030-3755
(575) 544-7280
(575) 544-7281
Mailing address
122 S GOLD AVE, SUITE 3, DEMING, NM 88030-3755
(575) 544-7280
(575) 544-7281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A8242
—
NM
01
—
NM011036
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/18/2006
Last updated
04/19/2012
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