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NPI Code Detail

MEDICARE: MR. ABRAHAM THOMAS BALSAMO P.A.-C

MEDICARE: MR. ABRAHAM THOMAS BALSAMO P.A.-C
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
1363A00000XPhysician AssistantPA2008-0042NM

General Provider Information

NPI Number : 1538317771
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ABRAHAM THOMAS BALSAMO P.A.-C
Provider Business Mailing Address
First Line : PO BOX 3141
Second Line :
City : CARLSBAD
State : NM
Zip : 88221-3141
Country : US
Telephone Number : 575-725-5552
Fax Number :
Provider Business Practice Location Address
First Line : 259 BLUEBERRY HILL RD
Second Line :
City : EL PRADO
State : NM
Zip : 87529-7305
Country : US
Telephone Number : 575-758-5858
Fax Number : 575-288-2436
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2008
Last Update Date : 03/10/2026

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