Healthcare Provider Details
I. General information
NPI: 1710672563
Provider Name (Legal Business Name): ERIKA J RIOS-CASILLAS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/07/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1511 S GRAND AVE
ROSWELL NM
88203-5407
US
IV. Provider business mailing address
PO BOX 843
PORTALES NM
88130-0843
US
V. Phone/Fax
- Phone: 575-623-3255
- Fax: 575-625-9901
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | DO2026-0115 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: