Organization
NM VA HEALTH CARE SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER CRAIG BUSTAMANTE (LPN)
(505) 710-9505
Entity
Organization
Contact information
Practice address
3121 LA JUNTA RD SW, ALBUQUERQUE, NM 87105-5643
(505) 710-9505
Mailing address
3121 LA JUNTA RD SW, ALBUQUERQUE, NM 87105-5643
(505) 710-9505
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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