Facts
- Status
- A
- Credential
- MD
- Type
- Individual
- Enumeration date
- 2006-05-16
- Last updated
- 2025-04-29
Licenses
- License TX
- L8016
- License TX
- L8016
- License NM
- MD2023-1644
Location
- Practice location
- 5419 N LOVINGTON HWY STE 31
- City
- HOBBS NM
- Postal code
- 882409136
- Phone
- 575-392-5191
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.