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General NPI Number Information
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NPI Number | 1831506831
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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 | 07/22/2014
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 10433 LAGRIMA DE ORO
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City | ALBUQUERQUE
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State | NM
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Zip | 87111
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Country | US
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Telephone | 505-299-4458
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Fax | 505-299-4450
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Provider Business Mailing Address
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Address Line | 10433 LAGRIMA DE ORO RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3727
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Country | US
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Telephone | 505-299-4458
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Fax | 505-299-4450
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | MS. 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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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DD2090
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License Number State | NM
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