=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235105800
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | X-RAY ASSOCIATES OF NEW MEXICO PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2006
-----------------------------------------------------
Last Update Date | 09/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8020 CONSTITUTION PLACE NE SUITE 101
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-998-1316
-----------------------------------------------------
Fax | 505-998-1308
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8020 CONSTITUTION PL NE STE 202
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87110-7640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-998-3096
-----------------------------------------------------
Fax | 505-998-3100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING SPECIALIST
-----------------------------------------------------
Name | MS. BETSY HUTCHINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 505-559-5629
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2085R0204X
-----------------------------------------------------
Taxonomy Name | Vascular & Interventional Radiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------