| Southwest Pediatric Care, Llc | |
|
1020 S 8th St Suite A Deming NM 88030-4007 | |
| (575) 936-4350 | |
| (575) 936-4351 |
| Full Name | Southwest Pediatric Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1020 S 8th St, Deming, New Mexico |
| Authorized Official Name and Position | Joel Rene Roque (COO / CO-OWNER) |
| Authorized Official Contact | 5759364350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Pediatric Care, Llc 1020 S 8th St A Deming NM 88030-4007 Ph: (575) 936-4350 | Southwest Pediatric Care, Llc 1020 S 8th St Suite A Deming NM 88030-4007 Ph: (575) 936-4350 |
| NPI Number | 1881089886 |
|---|---|
| Provider Enumeration Date | 04/06/2015 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 4981917481 |
|---|---|
| Medicare Enrollment ID | O20150713001662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881089886 | NPI | - | NPPES |
| 5558582 | Medicaid | NM | |
| 965048 | Medicaid | AZ | |
| 1376626564 | Other | AZ | TYPE 1 NPI FLORENCE C ROQUE |
| 48836893 | Medicaid | NM |
| Provider Name | Kathleen Cathey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003026279 PECOS PAC ID: 7719046788 Enrollment ID: I20130729000831 |
| Provider Name | Florence Roque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376626564 PECOS PAC ID: 1850375304 Enrollment ID: I20150713001586 |
| Provider Name | Rubeena Rehman Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497284533 PECOS PAC ID: 4284993999 Enrollment ID: I20180125000737 |
| Provider Name | Christina M Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265980544 PECOS PAC ID: 6800179797 Enrollment ID: I20190404000153 |
| Provider Name | Robin A Hopkins-wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386275741 PECOS PAC ID: 5597195537 Enrollment ID: I20200415001827 |
| Provider Name | Venus Robles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386223014 PECOS PAC ID: 4880002021 Enrollment ID: I20210428000418 |
| Provider Name | Carlos Ariel Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326781386 PECOS PAC ID: 0749667624 Enrollment ID: I20220514000146 |
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