Healthcare Provider Details

I. General information

NPI: 1982702890
Provider Name (Legal Business Name): MARIA FE SARDA FRILLES-HATOL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH 8TH STREET
DEMING NM
88030
US

IV. Provider business mailing address

1000 SOUTH 8TH STREET
DEMING NM
88030
US

V. Phone/Fax

Practice location:
  • Phone: 575-544-4975
  • Fax: 575-544-4785
Mailing address:
  • Phone: 575-544-4975
  • Fax: 575-544-4785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9354
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: