Organization
TRINITY FAMILY MEDICINE, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES DANIEL OTEO PA-C (CEO)
(575) 714-4505
Entity
Organization
Contact information
Practice address
701 ARIZONA ST. SUITE A, CLOVIS, NM 88101
(575) 742-3033
(575) 742-1133
Mailing address
701 ARIZONA ST. SUITE A, CLOVIS, NM 88101
(575) 742-3033
(575) 742-1133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46488260
—
NM
Enumeration date
08/20/2006
Last updated
01/26/2017
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