institution
De Baca Family Practice Clinic
Federally Qualified Health Center (FQHC) in Fort Sumner, New Mexico
NPI 1699082644

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 1699082644 and holds a License No. (New Mexico).

The current practice location address for De Baca Family Practice Clinic is 1001 Sumner Ave, Fort Sumner, NM and can be reached out via phone at 575-355-4431 and via fax at 575-355-4432.

Location: 1001 Sumner Ave, Fort Sumner, NM, 88119-0349
institution
Provider Profile Details
NPI Number
1699082644
Provider Name
De Baca Family Practice Clinic
Credential
Provider Entity Type
Organization
Address
1001 Sumner Ave, Fort Sumner, NM, 88119-0349
Phone Number
575-355-4431
Fax Number
575-355-4432
Provider Enumeration Date
09/10/2010
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38003384 05 NM
institution
Provider Business Practice Location Address Details
Address
1001 Sumner Ave
City
State
Zip
88119-0349
Phone Number
575-355-4431
Fax Number
575-355-4432
person
Provider Business Mailing Address Details
Address
1001 Sumner Ave
City
State
Zip
88119-0349
Phone Number
575-355-4431
Fax Number
575-355-4432
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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