institution
De Baca Family Practice Clinic
Federally Qualified Health Center (FQHC) in Santa Rosa, New Mexico
NPI 1962743534

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 Santa Rosa, NM. The NPI Number for De Baca Family Practice Clinic is 1962743534 and holds a License No. (New Mexico).

The current practice location address for De Baca Family Practice Clinic is 552 Us Hwy 54, Santa Rosa, NM and can be reached out via phone at 575-472-2414 and via fax at 575-472-2416.

Location: 552 Us Hwy 54, Santa Rosa, NM, 88119-0349
institution
Provider Profile Details
NPI Number
1962743534
Provider Name
De Baca Family Practice Clinic
Credential
Provider Entity Type
Organization
Address
552 Us Hwy 54, Santa Rosa, NM, 88119-0349
Phone Number
575-472-2414
Fax Number
575-472-2416
Provider Enumeration Date
03/07/2013
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
84331534 05 NM
institution
Provider Business Practice Location Address Details
Address
552 Us Hwy 54
City
State
Zip
88435
Phone Number
575-472-2414
Fax Number
575-472-2416
person
Provider Business Mailing Address Details
Address
552 Us Hwy 54
City
State
Zip
88435
Phone Number
575-472-2414
Fax Number
575-472-2416
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
(New Mexico)
Definition
Definition to come...
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