Healthcare Provider Details

I. General information

NPI: 1992628911
Provider Name (Legal Business Name): XAVIER VIGIL DN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE NM
87102-3540
US

IV. Provider business mailing address

5271 NA PALI ST NE
ALBUQUERQUE NM
87111-1961
US

V. Phone/Fax

Practice location:
  • Phone: 505-948-8634
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License NumberDN2026-0002
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: