Healthcare Provider Details

I. General information

NPI: 1568436723
Provider Name (Legal Business Name): ARTEMIO D BRAMBILA PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 YALE BLVD NE
ALBUQUERQUE NM
87131-5631
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-0053
  • Fax: 505-272-0052
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number481
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: