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General NPI Number Information
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NPI Number | 1134304389
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Entity Type | Organization
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Legal Business Name | DONA ANA FAMILY CLINIC PC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 2301 SATURN CIR
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City | LAS CRUCES
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State | NM
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Zip | 88012-7727
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Country | US
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Telephone | 575-382-0014
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Fax | 575-382-0015
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Provider Business Mailing Address
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Address Line | 2301 SATURN CIR
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City | LAS CRUCES
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State | NM
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Zip | 88012-7727
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Country | US
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Telephone | 575-382-0014
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Fax | 575-382-0015
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Authorized Official
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Title or Position | OWNER
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Name | DR. RENE A GUERRERO
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Credential | MD
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Telephone | 575-382-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 85-39
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License Number State | NM
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