Organization
PHC-LAS CRUCES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7688
Entity
Organization
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 522-8641
(575) 521-5013
Mailing address
PO BOX 6310, LAS CRUCES, NM 88006-6310
(575) 521-5370
(575) 521-5376
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26001373
—
NM
Enumeration date
07/25/2006
Last updated
01/15/2026
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