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General NPI Number Information
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NPI Number | 1689480667
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Entity Type | Organization
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Legal Business Name | AGAPE ANESTHESIA & PERIOPERATIVE
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1205 S TELSHOR BLVD STE A
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City | LAS CRUCES
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State | NM
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Zip | 88011-4748
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Country | US
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Telephone | 575-222-0127
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Fax | 575-652-3255
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Provider Business Mailing Address
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Address Line | 1205 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-4748
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Country | US
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Telephone | 575-222-0127
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Fax | 575-652-3255
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JESSE HOLGUIN
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Credential |
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Telephone | 575-222-0127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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