Individual
TEX W ANDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TRADITIONAL PRACTITI
Contact information
Practice address
2314 SOUTHWEST HIGHLAND DRIVE, CROWNPOINT, NM 87313
(505) 786-2111
(505) 786-2020
Mailing address
PO BOX 1144, CROWNPOINT, NM 87313-1144
(505) 786-2111
(505) 786-2020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860092335
BEHAVIORAL HEALTH SERVICE
NM
Enumeration date
05/25/2011
Last updated
07/31/2019
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