Organization
LAS CRUCES RADIOLOGY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMAKRISHNA DEVASTHALI (MD/ PRESIDENT)
(575) 449-7005
Entity
Organization
Contact information
Practice address
160 ROADRUNNER PARKWAY, LAS CRUCES, NM 88011
(575) 449-7005
(575) 449-7006
Mailing address
PO BOX 13638, LAS CRUCES, NM 88013-3638
(575) 449-7005
(575) 449-7006
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43844
—
NM
01
—
DD3226
RR MEDICARE
—
01
—
NM010679
BCBS OF NM
NM
Enumeration date
06/13/2006
Last updated
01/13/2017
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