Healthcare Provider Details

I. General information

NPI: 1063759330
Provider Name (Legal Business Name): HIDALGO MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 N POPE ST
SILVER CITY NM
88061-5161
US

IV. Provider business mailing address

530 DE MOSS ST
LORDSBURG NM
88045-2618
US

V. Phone/Fax

Practice location:
  • Phone: 575-800-1467
  • Fax: 575-313-8236
Mailing address:
  • Phone: 575-800-1467
  • Fax: 575-694-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number3431
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL OTERO
Title or Position: CEO
Credential:
Phone: 575-800-1467