Organization
SOUTHWEST HEART PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY A BOULWARE M.D. (OWNER)
(505) 522-7247
Entity
Organization
Contact information
Practice address
4351 E LOHMAN AVE STE 405, LAS CRUCES, NM 88011-8261
(575) 522-2233
(575) 522-2266
Mailing address
4351 E LOHMAN AVE STE 405, LAS CRUCES, NM 88011-8261
(575) 522-2233
(575) 522-2266
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56428006
—
NM
Enumeration date
11/08/2006
Last updated
01/22/2020
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