Healthcare Provider Details
I. General information
NPI: 1386747467
Provider Name (Legal Business Name): MARGARET J. BYERS, DO, SC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 S TRIVIZ DR STE H
LAS CRUCES NM
88001-0601
US
IV. Provider business mailing address
2100 S TRIVIZ DR STE H
LAS CRUCES NM
88001-0601
US
V. Phone/Fax
- Phone: 505-522-9793
- Fax: 505-532-9019
- Phone: 505-522-9793
- Fax: 505-532-9019
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 1230-03 |
| License Number State | NM |
VIII. Authorized Official
Name:
MARGARET
J
BYERS
Title or Position: PRESIDENT
Credential: DO
Phone: 505-522-9793