Healthcare Provider Details

I. General information

NPI: 1609794221
Provider Name (Legal Business Name): PRESBYTERIAN HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CENTRAL AVE SE
ALBUQUERQUE NM
87106-4930
US

IV. Provider business mailing address

PO BOX 209483
DALLAS TX
75320-9483
US

V. Phone/Fax

Practice location:
  • Phone: 505-923-1100
  • Fax:
Mailing address:
  • Phone: 505-923-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA CHAVIRA
Title or Position: CASH POSTER
Credential:
Phone: 505-923-6411