Organization
NORTE VISTA MEDICAL ARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENARD WAGNER M.D. (OWNER)
(505) 396-3529
Entity
Organization
Contact information
Practice address
1103 W TAOS ST, HOBBS, NM 88240-1111
(505) 396-3529
Mailing address
PO BOX 1798, HOBBS, NM 88241-1798
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86141
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649216896
NPI
NM
Enumeration date
07/13/2007
Last updated
02/14/2008
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