Healthcare Provider Details

I. General information

NPI: 1811071244
Provider Name (Legal Business Name): OBGYN CONSULTANTS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE STE 401
LAS CRUCES NM
88011
US

IV. Provider business mailing address

4351 E LOHMAN AVE STE 401
LAS CRUCES NM
88011
US

V. Phone/Fax

Practice location:
  • Phone: 505-522-4767
  • Fax: 505-522-3607
Mailing address:
  • Phone: 505-522-4767
  • Fax: 505-522-3607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ISMAEL PADILLA LOPEZ
Title or Position: MD
Credential: MD
Phone: 505-522-4767