institution
De Baca Family Practice Clinic
Federally Qualified Health Center (FQHC) in Fort Sumner, New Mexico
NPI 1003855032

De Baca Family Practice Clinic is a Federally Qualified Health Center (FQHC) based in Fort Sumner, NM and is specialized in Federally Qualified Health Center (FQHC). De Baca Family Practice Clinic practices in Fort Sumner, NM. The NPI Number for De Baca Family Practice Clinic is 1003855032 and holds a License No. (New Mexico).

The current practice location address for De Baca Family Practice Clinic is 546 N. Tenth St, Fort Sumner, NM and can be reached out via phone at 505-355-2414.

Location: 546 N. Tenth St, Fort Sumner, NM, 88119-0349
institution
Provider Profile Details
NPI Number
1003855032
Provider Name
De Baca Family Practice Clinic
Credential
Provider Entity Type
Organization
Address
546 N. Tenth St, Fort Sumner, NM, 88119-0349
Phone Number
505-355-2414
Fax Number
Provider Enumeration Date
06/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
321863 01 NM NGS ID
institution
Provider Business Practice Location Address Details
Address
546 N. Tenth St
City
State
Zip
88119
Phone Number
505-355-2414
Fax Number
person
Provider Business Mailing Address Details
Address
546 N. Tenth St
City
State
Zip
88119
Phone Number
505-355-2414
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
()
Definition
Definition to come...
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