Healthcare Provider Details

I. General information

NPI: 1457451593
Provider Name (Legal Business Name): ARMANDO CARLOS ANGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 PAISANO ROAD
LAS CRUCES NM
88005-3931
US

IV. Provider business mailing address

1820 PAISANO ROAD
LAS CRUCES NM
88005-3931
US

V. Phone/Fax

Practice location:
  • Phone: 505-644-4221
  • Fax: 915-564-7877
Mailing address:
  • Phone: 505-644-4221
  • Fax: 915-564-7877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number78-3
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: