MEDICARE: CMV VASCULAR SERVICES

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	293D00000X	Physiological Laboratory		NM
2	305S00000X	Point of Service

General Provider Information

NPI Number	:	1588904361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CMV VASCULAR SERVICES

Provider Business Mailing Address
First Line	:	1431 VISTA DEL CERRO
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-8906
Country	:	US
Telephone Number	:	575-640-7393
Fax Number	:	575-522-0825

Provider Business Practice Location Address
First Line	:	3850 FOOTHILLS RD
Second Line	:	SUITE 3
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4632
Country	:	US
Telephone Number	:	575-640-7393
Fax Number	:	575-522-0825

Authorized Official
Title or Position	:	TECHNICAL DIRECTOR
Name	:	MRS. CYNTHIA M VALENZUELA
Credential	:	RVT, RVS
Telephone Number	:	575-640-7393

Provider Enumeration Date	:	02/15/2013
Last Update Date	:	10/04/2025

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