Healthcare Provider Details

I. General information

NPI: 1366672826
Provider Name (Legal Business Name): MUNIF HUSSEIN ALKOUZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2009
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 S TELSHOR BLVD SUITE 207
LAS CRUCES NM
88011-4951
US

IV. Provider business mailing address

PO BOX 6310
LAS CRUCES NM
88006-6310
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-6806
  • Fax: 575-521-8033
Mailing address:
  • Phone: 575-522-6806
  • Fax: 575-521-8033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD2012-0255
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: