Healthcare Provider Details

I. General information

NPI: 1619604204
Provider Name (Legal Business Name): ALAMO WOMEN'S CLINIC OF ALBUQUERQUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 05/13/2025
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 MONTGOMERY BLVD NE BUILDING 3, UNIT B
ALBUQUERQUE NM
87111
US

IV. Provider business mailing address

10151 MONTGOMERY BLVD NE, BUILDING 3, UNIT B, ALBUQUERQ
ALBUQUERQUE NM
87111
US

V. Phone/Fax

Practice location:
  • Phone: 505-494-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KENDRA L TOMLIN
Title or Position: ADMINISTRATIVE ASSISTANT/INSURANCE
Credential:
Phone: 505-494-5700