De Anda, Jose Luis

De Anda, Jose Luis is an individual health care provider with primary practice located at 1265 Anthony Dr , Anthony NM 88021. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. De Anda, Jose Luis can be contacted via phone (505) 882-2956.

Contact Information

Primary practice address
1265 Anthony Dr Anthony NM 88021
Phone: (505) 882-2956
Fax: (505) 882-1863
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2002-1081 New Mexico
Allopathic & Osteopathic Physicians / Pediatrics 208000000X L4904 Texas

Profile Details

NPI number 1386642528
LBN Legal business name De Anda, Jose Luis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386642528 NPPES
Texas MEDICAID 1595985021
Texas MEDICAID 17907543

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