Organization
HERMOSA PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL GALLEGOS MD (PRESIDENT)
(505) 454-1907
Entity
Organization
Contact information
Practice address
8004 CONSTITUTION PL NE, ALBUQUERQUE, NM 87110-7628
(505) 454-1907
Mailing address
8004 CONSTITUTION PL NE, ALBUQUERQUE, NM 87110-7628
(505) 454-1907
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
93262
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z5721
—
NM
Enumeration date
04/24/2014
Last updated
04/24/2014
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