Healthcare Provider Details

I. General information

NPI: 1528338217
Provider Name (Legal Business Name): FRANCISCO ALONZO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 S MAIN ST STE A
LAS CRUCES NM
88005-3113
US

IV. Provider business mailing address

3960 TIERRA IRIS PL
EL PASO TX
79938-5344
US

V. Phone/Fax

Practice location:
  • Phone: 575-386-4184
  • Fax:
Mailing address:
  • Phone: 915-235-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: