Individual
DR. TANIA D PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
105 MILLS AVE STE 200, LAS VEGAS, NM 87701-4169
(505) 426-3795
(505) 425-2653
Mailing address
105 MILLS AVE STE 200, LAS VEGAS, NM 87701-4169
(505) 426-3795
(505) 425-2653
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
DR0056511
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04009221
—
CO
01
—
1649294125
BCBS
NM
01
—
202034211
PRESBYTRIAN HEALTH PLAN
NM
05
—
64622835
—
NM
01
—
A-1373-06
NM LICENSE
NM
01
—
NM301797
MEDICARE PTAN
NM
Enumeration date
07/27/2006
Last updated
03/13/2023
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