Aztec Family Practice Pa

LBN: Aztec Family Practice Pa
Aztec Family Practice Pa is an health care organization with primary practice located at 406 S Park Ave , Aztec NM 87410-2226. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Aztec Family Practice Pa can be contacted via phone (505) 334-2852, or through Poe, Bryan via phone (505) 334-2852.

Contact Information

Primary practice address
406 S Park Ave Aztec NM 87410-2226
Phone: (505) 334-2852
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Poe, Bryan
Phone: (505) 334-2852

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X A-834-86 New Mexico

Profile Details

NPI number 1336348135
LBN Legal business name Aztec Family Practice Pa
DBA Doing business as
Authorized official Poe, Bryan
Entity Organization
Organization subpart 1 No
Enumeration date Jul 12th, 2007
Last updated May 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336348135 NPPES
New Mexico MEDICAID 40931

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