Individual
JOSE LUIS HENAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 E LOHMAN AVE STE B, LAS CRUCES, NM 88011-8268
(575) 522-5752
(575) 522-5722
Mailing address
3821 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4679
(505) 998-7400
(505) 998-7740
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13298
SD
207RN0300X
Nephrology Physician
Primary
MD2023-1540
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15136728
—
NM
01
—
6L7121
MEDICARE
NM
Enumeration date
04/12/2017
Last updated
10/27/2025
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