Healthcare Provider Details

I. General information

NPI: 1922208230
Provider Name (Legal Business Name): LUCIA CIES, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 SAINT MICHAELS DR STE B201
SANTA FE NM
87505-7681
US

IV. Provider business mailing address

435 SAINT MICHAELS DR STE B201
SANTA FE NM
87505-7681
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-1213
  • Fax: 505-983-9546
Mailing address:
  • Phone: 505-983-1213
  • Fax: 505-983-9546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. NANCY GAGAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-983-1213