Healthcare Provider Details

I. General information

NPI: 1437650934
Provider Name (Legal Business Name): SANDRA LIZET OROZCO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZET OROZCO-MARQUEZ

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-2682
US

IV. Provider business mailing address

1917 N TURNER ST STE 100
HOBBS NM
88240-2732
US

V. Phone/Fax

Practice location:
  • Phone: 505-322-6687
  • Fax:
Mailing address:
  • Phone: 575-602-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA18180
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2018-0010
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: