Organization
WHITE SANDS FAMILY PRACTICE CLINIC, INC.
Active
Other names
Vdex Diabetes
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMBER BRYANT (EXECUTIVE ADMINISTRATOR)
(575) 488-2720
Entity
Organization
Contact information
Practice address
916 N WHITE SANDS BLVD, ALAMOGORDO, NM 88310-6926
(575) 488-2720
(575) 936-4077
Mailing address
PO BOX 836, ALAMOGORDO, NM 88311-0836
(575) 488-2720
(575) 488-2721
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
98-288
NM
261Q00000X
Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20559330
—
NM
01
—
NM007E60
BCBS GROUP NUMBER
NM
Enumeration date
07/13/2006
Last updated
11/14/2024
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