Individual
JOSE BAUTISTA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5076
(575) 522-8641
Mailing address
11549 MACAW PALM DR, EL PASO, TX 79936-1486
(915) 538-8452
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
IN00004887
NM
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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