Healthcare Provider Details

I. General information

NPI: 1487218434
Provider Name (Legal Business Name): ANGELA BARNES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 UNSER BLVD SE STE 19100
RIO RANCHO NM
87124-4740
US

IV. Provider business mailing address

PO BOX 26666
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 661-212-3925
  • Fax: 212-939-1462
Mailing address:
  • Phone: 661-212-3925
  • Fax: 212-939-1462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD2024-1230
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: