Healthcare Provider Details

I. General information

NPI: 1174448419
Provider Name (Legal Business Name): RAZA ASLAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 S TELSHOR BLVD
LAS CRUCES NM
88011-5069
US

IV. Provider business mailing address

3245 E UNIVERSITY AVE APT 1404
LAS CRUCES NM
88011-9190
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-6489
  • Fax: 575-521-5568
Mailing address:
  • Phone: 575-339-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRS2026-0079
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: