Healthcare Provider Details

I. General information

NPI: 1003006040
Provider Name (Legal Business Name): NEW MEXICO SURGICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 ENCINO PL NE
ALBUQUERQUE NM
87102-2619
US

IV. Provider business mailing address

711 ENCINO PL NE
ALBUQUERQUE NM
87102
US

V. Phone/Fax

Practice location:
  • Phone: 505-843-7901
  • Fax: 505-843-6384
Mailing address:
  • Phone: 505-843-7901
  • Fax: 505-843-6384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT LOWE
Title or Position: PRESIDENT
Credential: MD
Phone: 505-843-7901