Organization
HIDALGO MEDICAL SERVICES
Active
Parent organization
HIDALGO MEDICAL SERVICES
Other names
Ena Mitchell Senior and Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
HIDALGO MEDICAL SERVICES
Authorized official
DANIEL OTERO (CEO)
(575) 542-2322
Entity
Organization
Contact information
Practice address
532 DEMOSS ST., LORDSBURG, NM 88045-2618
(575) 542-2353
(575) 542-2388
Mailing address
530 DE MOSS ST, LORDSBURG, NM 88045-2618
(575) 542-2307
(575) 542-2388
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
3429
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1 T 3429
OPERATORS LICENSE
NM
01
—
3429
NM DOH OPERATORS LICENSE
NM
Enumeration date
02/12/2013
Last updated
03/04/2016
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