Healthcare Provider Details

I. General information

NPI: 1811984453
Provider Name (Legal Business Name): BERNADETTE L SAIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W COUNTRY CLUB RD
ROSWELL NM
88201-5209
US

IV. Provider business mailing address

214 CENTERVIEW DR SUITE 350
BRENTWOOD TN
37027-5274
US

V. Phone/Fax

Practice location:
  • Phone: 505-622-8170
  • Fax:
Mailing address:
  • Phone: 615-309-3300
  • Fax: 615-309-3338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA1202-02
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: