Healthcare Provider Details

I. General information

NPI: 1215813183
Provider Name (Legal Business Name): AZTEC URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 E MAIN ST
FARMINGTON NM
87402-7624
US

IV. Provider business mailing address

2577 MAIN AVE
DURANGO CO
81301-5919
US

V. Phone/Fax

Practice location:
  • Phone: 505-326-6000
  • Fax: 505-334-7759
Mailing address:
  • Phone: 505-326-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRYAN JAMES VINCENT
Title or Position: CEO
Credential:
Phone: 970-247-8382