| Organization Name: | DERMATOLOGY OF LAS CRUCES, PC |
| NPI Number: | 1780075135 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREW L ONDO (OWNER/PHYSICIAN) |
| Mailing Address: | 3865 Foothills Rd Las Cruces |
| State: | NM US |
| Postal Code: | 880115091 |
| Phone Number: | 5755217117 |
| Fax Number: | 5755217226 |
| NPI Enumeration Date: | 02/06/2015 |
| NPI Last Update Date: | 05/31/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 97-332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |