Individual
TERRY MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
UNIVERSITY OF NEW MEXICO MSC09 5040, ALBUQUERQUE, NM 87131-1000
(505) 925-0857
Mailing address
335 TULANE PL NE, ALBUQUERQUE, NM 87106-2153
(770) 364-1163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005610
GA
363A00000X
Physician Assistant
Primary
PA2013-0012
NM
Other
Enumeration date
04/07/2010
Last updated
03/17/2018
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