Healthcare Provider Details

I. General information

NPI: 1306287040
Provider Name (Legal Business Name): JAMES ARLEN BESHIRES JR. D.O.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8631 GOLF COURSE RD NW SUITE D
ALBUQUERQUE NM
87114-6347
US

IV. Provider business mailing address

8631 GOLF COURSE RD NW SUITE D
ALBUQUERQUE NM
87114-6347
US

V. Phone/Fax

Practice location:
  • Phone: 505-453-0120
  • Fax:
Mailing address:
  • Phone: 505-453-0120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1042
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: