| Catron County Cowboy Clinic Llc | |
|
829 N Manzanita St Las Cruces NM 88001-2248 | |
| (715) 566-1652 | |
| (575) 800-5910 |
| Full Name | Catron County Cowboy Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 829 N Manzanita St, Las Cruces, New Mexico |
| Authorized Official Name and Position | Jenifer Deziel (OWNER) |
| Authorized Official Contact | 7155661652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catron County Cowboy Clinic Llc 829 N Manzanita St Las Cruces NM 88001-2248 Ph: (715) 566-1652 | Catron County Cowboy Clinic Llc 829 N Manzanita St Las Cruces NM 88001-2248 Ph: (715) 566-1652 |
| NPI Number | 1770382434 |
|---|---|
| Provider Enumeration Date | 03/13/2025 |
| Last Update Date | 03/13/2025 |
| Medicare PECOS PAC ID | 6709300825 |
|---|---|
| Medicare Enrollment ID | O20250410002029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770382434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | Jenifer Deziel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336589969 PECOS PAC ID: 8426282120 Enrollment ID: I20221114000022 |
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App Of New Mexico Hm Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4311 E Lohman Ave, Las Cruces, NM 88011 Phone: 575-556-7600 Fax: 629-216-0568 |