Organization Name: | RIO GRANDE MEDICAL GROUP, LTD |
NPI Number: | 1013900794 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HASAN ADNAN (VICE PRESIDENT) |
Mailing Address: | 4371 E Lohman Ave Las Cruces |
State: | NM US |
Postal Code: | 880118255 |
Phone Number: | 5755328900 |
Fax Number: | 5755328910 |
NPI Enumeration Date: | 08/26/2005 |
NPI Last Update Date: | 11/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207KA0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Allergy & Immunology |
Taxonomy Specialization: | Allergy |
Taxonomy Definition: |