Individual
LISA A JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9210 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-5891
(505) 298-2505
(505) 298-2985
Mailing address
5904 HOLLY AVE NE, ALBUQUERQUE, NM 87113-2472
(505) 298-2505
(505) 298-2985
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20020168
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15756734
—
NM
Enumeration date
07/12/2006
Last updated
01/28/2019
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