Organization
ST. VINCENT HOSPITAL
Active
Other names
Pojoaque Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
J ALEX VALDEZ (CEO PRESIDENT)
(505) 913-5202
Entity
Organization
Contact information
Practice address
5 PETROGLYPH CIR, SUITE A, SANTA FE, NM 87506-1001
(505) 455-1962
(505) 455-2355
Mailing address
5 PETROGLYPH CIR, SUITE A, SANTA FE, NM 87506-1001
(505) 455-1962
(505) 455-2355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9509
—
NM
Enumeration date
03/23/2007
Last updated
03/13/2012
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