Healthcare Provider Details

I. General information

NPI: 1760016174
Provider Name (Legal Business Name): TRANON BASHTON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MONTERREY RD NE
RIO RANCHO NM
87144-1584
US

IV. Provider business mailing address

1500 MONTERREY RD NE
RIO RANCHO NM
87144-1584
US

V. Phone/Fax

Practice location:
  • Phone: 505-644-0685
  • Fax: 505-557-1156
Mailing address:
  • Phone: 505-644-0685
  • Fax: 505-557-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code246QH0401X
TaxonomyHemapheresis Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: