Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2019-08-28
- Last updated
- 2026-06-02
Licenses
The registry row did not include a license.
Location
- Practice location
- 199 HIGHWAY 50, BLDG A
- City
- PECOS NM
- Postal code
- 87552
- Phone
- 505-757-6482
Organization contact
- Name
- DOUG SMITH
- Title
- Executive VP
- Phone
- 5059825565
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.