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Mayedel A. San Jose Pc
Primary Care Clinic/Center in Santa Teresa, New Mexico
NPI 1083305510

Mayedel A. San Jose Pc is a Primary Care Clinic/Center based in Santa Teresa, NM and is specialized in Primary Care. Mayedel A. San Jose Pc practices in Santa Teresa, NM. The NPI Number for Mayedel A. San Jose Pc is 1083305510 and holds a License No. (New Mexico).

The current practice location address for Mayedel A. San Jose Pc is 1245 Country Club Rd Ste 200, Santa Teresa, NM and can be reached out via phone at 575-332-4633 and via fax at 877-209-8941.

Location: 1245 Country Club Rd Ste 200, Santa Teresa, NM, 88008-9743
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083305510
Provider Name
Mayedel A. San Jose Pc
Credential
Provider Entity Type
Organization
Address
1245 Country Club Rd Ste 200, Santa Teresa, NM, 88008-9743
Phone Number
575-332-4633
Fax Number
877-209-8941
Provider Enumeration Date
05/16/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1245 Country Club Rd Ste 200
City
Santa Teresa
State
New Mexico
Zip
88008-9743
Phone Number
575-332-4633
Fax Number
877-209-8941
person
Provider Business Mailing Address Details
Address
1245 Country Club Rd Ste 200
City
Santa Teresa
State
New Mexico
Zip
88008-9743
Phone Number
575-332-4633
Fax Number
877-209-8941
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
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