MEDICARE: DR. GALEN CASTILLO LOUGHREY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD2011-0622	NM

General Provider Information

NPI Number	:	1225271083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GALEN CASTILLO LOUGHREY MD

Provider Business Mailing Address
First Line	:	6900 GONZALES RD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87121
Country	:	US
Telephone Number	:	505-831-2534
Fax Number	:	505-831-4123

Provider Business Practice Location Address
First Line	:	6900 GONZALES RD SW
Second Line	:	FIRST CHOICE COMMUNITY HEALTHCARE - ALAMOSA MEDICAL
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87121-2401
Country	:	US
Telephone Number	:	505-831-2534
Fax Number	:	505-831-4123

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2009
Last Update Date	:	03/28/2019

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