MEDICARE: DR. JOSE LUIS DE ANDA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	2002-1081	NM
2	208000000X	Pediatrics Physician	L4904	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386642528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE LUIS DE ANDA MD

Provider Business Mailing Address
First Line	:	PO BOX 4530
Second Line	:
City	:	ANTHONY
State	:	TX
Zip	:	79821-0047
Country	:	US
Telephone Number	:	505-882-2956
Fax Number	:	505-882-1863

Provider Business Practice Location Address
First Line	:	1265 ANTHONY DR
Second Line	:
City	:	ANTHONY
State	:	NM
Zip	:	88021
Country	:	US
Telephone Number	:	505-882-2956
Fax Number	:	505-882-1863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1649853920 — STEVEN ANDREW COSGROVE DMD
Practice Location Address:

855 ANTHONY DR
ANTHONY, NM
88021-9325

Practice Phone: 575-882-3607
Practice Fax:

1003812553 — LYDIA MACKLIN CNP
Practice Location Address:

855 ANTHONY DR
ANTHONY, NM
88021

Practice Phone: 575-882-5706
Practice Fax: 575-882-2909

1548269210 — HECTOR IGNACIO OCARANZA M.D.
Practice Location Address:

1265 ANTHONY DR.
ANTHONY, NM
88021

Practice Phone: 575-882-2956
Practice Fax: 575-882-1863

1699748921 — LA CLINICA DE FAMILIA, INCORPORATED
Practice Location Address:

855 ANTHONY DR
ANTHONY, NM
88021-9325

Practice Phone: 575-882-5706
Practice Fax: 575-882-2909

1043286586 — JOSE LEOS FLORES MD
Practice Location Address:

855 ANTHONY DR
ANTHONY, NM
88021

Practice Phone: 575-882-5706
Practice Fax: 575-882-2909

1912941436 — JOSE ROBERTO VELASQUEZ CASE MANAGER
Practice Location Address:

826 ANTHONY DR
ANTHONY, NM
88021

Practice Phone: 575-201-5135
Practice Fax: 575-449-4052

Directions to “ DR. JOSE LUIS DE ANDA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.