Healthcare Provider Details

I. General information

NPI: 1235108549
Provider Name (Legal Business Name): PULMONARY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 HILLRISE DR
LAS CRUCES NM
88011-4702
US

IV. Provider business mailing address

2900 HILLRISE DR
LAS CRUCES NM
88011-4702
US

V. Phone/Fax

Practice location:
  • Phone: 505-556-1300
  • Fax: 505-556-1301
Mailing address:
  • Phone: 505-556-1300
  • Fax: 505-556-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ERNEST RHETT JABOUR
Title or Position: OWNER
Credential: MD
Phone: 505-556-1300