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Organization

RIO GRANDE MEDICAL, LTD

Active
Parent organization
RIO GRANDE MEDICAL GROUP, LTD
Organization subpart
Yes

Provider details

NPI number
Legal business name
RIO GRANDE MEDICAL GROUP, LTD
Authorized official
EUGENE SAMUEL (CEO)
(575) 532-8900
Entity
Organization

Contact information

Practice address
4351 E LOHMAN AVE, SUITE 301, LAS CRUCES, NM 88011-8259
(575) 532-8900
(575) 532-8963
Mailing address
4351 E LOHMAN AVE, SUITE 301, LAS CRUCES, NM 88011-8259
(575) 532-8900
(575) 532-8963

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician

Other

Enumeration date
01/12/2010
Last updated
01/12/2010
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