Organization
NEW MEXICO VEIN TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALID Y. KHAN (MD/OWNER)
(575) 522-1974
Entity
Organization
Contact information
Practice address
141 N ROADRUNNER PKWY STE 137, LAS CRUCES, NM 88011-2001
(575) 522-1974
(575) 522-5209
Mailing address
141 N ROADRUNNER PKWY STE 137, LAS CRUCES, NM 88011-2001
(575) 522-1974
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6866
—
NM
01
—
DD6448
RR MEDICARE
—
Enumeration date
06/13/2006
Last updated
06/07/2022
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