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General NPI Number Information
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NPI Number | 1609960624
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CARDIOLOGY CONSULTANTS OF NEW MEXICO
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 2405 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-5049
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Country | US
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Telephone | 575-522-5353
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Fax | 575-522-7571
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Provider Business Mailing Address
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Address Line | 2405 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-5049
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Country | US
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Telephone | 575-522-5353
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Fax | 575-522-7571
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENT RICHARDS
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Credential | MD
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Telephone | 575-522-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 76-250
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License Number State | NM
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