| Organization Name: | PECOS VALLEY OF NEW MEXICO, LLC |
| NPI Number: | 1326004755 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBBIE T BREWER (DIRECTOR) |
| Mailing Address: | 2420 W Pierce St Suite 200 B Carlsbad |
| State: | NM US |
| Postal Code: | 882203543 |
| Phone Number: | 5056281589 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2006 |
| NPI Last Update Date: | 02/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |