Individual
ABRAHAM VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3303 OAK ST, LAS CRUCES, NM 88005-7725
(575) 932-8425
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74481
—
NM
Enumeration date
10/07/2014
Last updated
10/19/2015
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