MEDICARE: DR. FERNANDO J INDACOCHEA 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	208000000X	Pediatrics Physician	MD2012-0871	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720089519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERNANDO J INDACOCHEA MD

Provider Business Mailing Address
First Line	:	4395 ISLETA CT
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4297
Country	:	US
Telephone Number	:	304-902-0443
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 E. LOHMAN AVE.
Second Line	:	SUITE A
City	:	LAS CRUCES
State	:	NM
Zip	:	88011
Country	:	US
Telephone Number	:	575-532-9077
Fax Number	:	575-532-9221

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	09/22/2020

Similar Medicare Providers

1891633061 — HARITH ALAA HUSSEIN ZWAIN MBBS
Practice Location Address:

4311 E LOHMAN AVE
LAS CRUCES, NM
88011-8255

Practice Phone: 575-566-7600
Practice Fax:

1346034600 — JULIAN ELI ORDUNO
Practice Location Address:

1250 HILLRISE CIR
LAS CRUCES, NM
88011-4741

Practice Phone: 575-288-1881
Practice Fax: 575-288-1889

1134854656 — DEVIN R LOPEZ
Practice Location Address:

1250 HILLRISE CIR
LAS CRUCES, NM
88011-4741

Practice Phone: 575-288-1881
Practice Fax: 575-288-1889

1952197808 — GARRETT DEE DO
Practice Location Address:

4311 E LOHMAN AVE
LAS CRUCES, NM
88011-8255

Practice Phone: 575-556-7600
Practice Fax:

1235077751 — AHMED IBRAHIM MD
Practice Location Address:

4351 E LOHMAN AVE STE 300
LAS CRUCES, NM
88011-8262

Practice Phone: 575-556-7600
Practice Fax: 575-556-7600

1295673531 — ALAMEEN AHMED ABDELRAHMAN AL SABBAH MD
Practice Location Address:

4311 E LOHMAN AVE
LAS CRUCES, NM
88011-8255

Practice Phone: 575-556-7600
Practice Fax:

1770186579 — ANNALISE EATON
Practice Location Address:

1250 HILLRISE CIR
LAS CRUCES, NM
88011-4741

Practice Phone: 888-805-0759
Practice Fax:

Directions to “ DR. FERNANDO J INDACOCHEA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.