Healthcare Provider Details

I. General information

NPI: 1063027761
Provider Name (Legal Business Name): COMPASSION CARE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHWAY 195 STE A
ELEPHANT BUTTE NM
87935-1820
US

IV. Provider business mailing address

PO BOX 449
ELEPHANT BUTTE NM
87935-0449
US

V. Phone/Fax

Practice location:
  • Phone: 575-744-4872
  • Fax:
Mailing address:
  • Phone: 575-744-4872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DALLAS LIPSCOMB
Title or Position: OWNER
Credential: PA
Phone: 575-744-4872