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General NPI Number Information
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NPI Number | 1134081581
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Entity Type | Organization
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Legal Business Name | BYLYHL HEIGHTS LLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 400 E COUNTRY CLUB RD
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City | ROSWELL
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State | NM
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Zip | 88201-6527
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Country | US
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Telephone | 575-420-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 400 E COUNTRY CLUB RD
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City | ROSWELL
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State | NM
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Zip | 88201-6527
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Country | US
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Telephone | 575-420-0743
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/OWNER
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Name | JACOB ONEIL
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Credential | FNP-BC
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Telephone | 575-420-0743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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