| Organization Name: | FAMILY PRACTICE MEDICAL AND DIETETIC MEDICAL THERAPY |
| NPI Number: | 1609199447 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSE ROSALES (OWNER) |
| Mailing Address: | 2904 Hillrise Dr Las Cruces |
| State: | NM US |
| Postal Code: | 880114702 |
| Phone Number: | 5755325386 |
| Fax Number: | 5755325449 |
| NPI Enumeration Date: | 03/08/2010 |
| NPI Last Update Date: | 03/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DT06119 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |