Individual
AUDREY VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 W COUNTRY CLUB RD STE 101, ROSWELL, NM 88201-5222
(575) 622-1841
(575) 622-5317
Mailing address
350 W COUNTRY CLUB RD STE 101, ROSWELL, NM 88201-5222
(575) 622-1841
(575) 622-5317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
95-151
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E8609
—
NM
01
—
NPI & TIN
BCBS OF NM
NM
Enumeration date
09/29/2005
Last updated
09/15/2020
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