Doctor Name: | DR. ELIGIO ROBERTO PADILLA |
NPI Number: | 1023297447 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 170 |
Business Practice Address: | 1776 Montano Rd Nw Los Ranchos De Albuquerque, NM - 871073245 |
Business Phone Number: | 5053441776 |
Business Fax Number: | |
Mailing Address: | 1698 Tierra Del Rio Nw, ALBUQUERQUE |
State: | NM |
Postal Code: | 871073259 |
Phone Number: | 5053451879 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2007 |
NPI Last Update Date: | 11/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 170 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |