Organization
MESILLA VALLEY ANESTHESIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY S. MCCOMAS (MD/PRESIDENT)
(575) 532-7000
Entity
Organization
Contact information
Practice address
205 W. BOUTZ RD., BLDG #1, LAS CRUCES, NM 88005
(575) 532-7000
Mailing address
205 W. BOUTZ RD., BLDG #1, LAS CRUCES, NM 88005
(575) 532-7000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI7030
RR MEDICARE
—
05
—
K0756
—
NM
Enumeration date
06/13/2006
Last updated
12/15/2011
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