Individual
ALYSON P THAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3841 CORRALES RD, CORRALES, NM 87048-9311
(505) 792-3065
(505) 792-4004
Mailing address
PO BOX 2090, 3841 CORRALES ROAD, CORRALES, NM 87048-2090
(505) 792-3065
(505) 792-4004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86-346
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38687
—
NM
Enumeration date
08/15/2006
Last updated
03/11/2014
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