Organization
LAS VEGAS STAT CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M. EILEEN MADRID MD (BOARD PRESIDENT)
(505) 454-7945
Entity
Organization
Contact information
Practice address
260 MILLS AVE, LAS VEGAS, NM 87701-4125
(505) 425-6283
(505) 425-7196
Mailing address
PO BOX 2545, LAS VEGAS, NM 87701-2545
(505) 454-7945
(505) 425-7196
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51932253
—
NM
Enumeration date
07/30/2006
Last updated
08/22/2020
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