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General NPI Number Information
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NPI Number | 1528920212
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Entity Type | Organization
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Legal Business Name | DARREN HALTOM SPECIALTY PARTNERS OF NM II, LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1209 BONITA ST STE A
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City | GRANTS
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State | NM
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Zip | 87020-2103
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Country | US
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Telephone | 505-285-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 8300 CARMEL AVE NE STE 602
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-3150
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Country | US
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Telephone | 505-878-0700
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | KRYSTAL RICHARDSON
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Credential |
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Telephone | 214-934-7995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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