Organization
SANTA TERESA OCCMED CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA L. AYERS (ADMINISTRATIVE ASSISTANT)
(915) 842-0504
Entity
Organization
Contact information
Practice address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(505) 589-5005
Mailing address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(505) 589-5005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/26/2007
Last updated
11/26/2007
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