Healthcare Provider Details

I. General information

NPI: 1750359865
Provider Name (Legal Business Name): JORGE URIAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W. BOUTZ RD BLDG #1
LAS CRUCES NM
88005
US

IV. Provider business mailing address

205 W. BOUTZ RD BLDG #1
LAS CRUCES NM
88005
US

V. Phone/Fax

Practice location:
  • Phone: 575-532-7000
  • Fax: 575-532-7006
Mailing address:
  • Phone: 575-532-7000
  • Fax: 575-532-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number88-275
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: