Organization
ANITA M. ROYBAL FAMILY AND PREVENTIVE HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA M ROYBAL (M.D.)
(505) 234-1612
Entity
Organization
Contact information
Practice address
1316 JACKIE RD SE STE 400, SUITE 201, RIO RANCHO, NM 87124-1045
(505) 234-1612
(505) 234-1618
Mailing address
1316 JACKIE RD SE STE 400, SUITE 201, RIO RANCHO, NM 87124-1045
(505) 234-1612
(505) 234-1618
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
84110
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NMB2482
GROUP PTAN NUMBER
NM
01
—
NMB2482
GROUP PTAN NUMBER
—
05
—
Q6735
—
NM
Enumeration date
12/30/2010
Last updated
07/27/2016
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