MEDICARE: MR. FIDEL TYNER CURTIS B.A. CSW

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	171M00000X	Case Manager/Care Coordinator		NM
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1235433186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FIDEL TYNER CURTIS B.A. CSW

Provider Business Mailing Address
First Line	:	5601 DOMINGO RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-1610
Country	:	US
Telephone Number	:	505-268-5295
Fax Number	:	505-268-9967

Provider Business Practice Location Address
First Line	:	2301 YALE BLVD SE STE F
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4354
Country	:	US
Telephone Number	:	505-272-7033
Fax Number	:

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

Provider Enumeration Date	:	01/07/2011
Last Update Date	:	12/13/2024

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