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General NPI Number Information
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NPI Number | 1043008774
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Entity Type | Individual
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Provider Name | DANIEL HAWKS CCSS
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Gender | Male
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 4210 MEADOWLARK LN SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-1021
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Country | US
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Telephone | 505-738-6355
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Fax |
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Provider Business Mailing Address
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Address Line | 209 DELAMAR LOOP NW APT A
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-5155
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Country | US
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Telephone | 505-715-1243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NM
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