Organization
LA CLINICA DE FAMILIA, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGIL MEDINA (CEO)
(575) 526-1105
Entity
Organization
Contact information
Practice address
100 W GRIGGS AVE, LAS CRUCES, NM 88001-1234
(575) 647-2800
(575) 524-4266
Mailing address
385 CALLE DE ALEGRA, BLDG. A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4265
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29052289
—
NM
Enumeration date
06/01/2015
Last updated
09/18/2025
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