| Juan Tabo Family Medicine Pc | |
|
3309 Juan Tabo Blvd Ne Suite C Albuquerque NM 87111-5131 | |
| (505) 554-1786 | |
| (505) 508-2482 |
| Full Name | Juan Tabo Family Medicine Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3309 Juan Tabo Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Ben Muneta (REGISTERED AGENT) |
| Authorized Official Contact | 5055541786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan Tabo Family Medicine Pc 3309 Juan Tabo Blvd Ne Suite C Albuquerque NM 87111-5131 Ph: (505) 554-1786 | Juan Tabo Family Medicine Pc 3309 Juan Tabo Blvd Ne Suite C Albuquerque NM 87111-5131 Ph: (505) 554-1786 |
| NPI Number | 1073825816 |
|---|---|
| Provider Enumeration Date | 07/09/2010 |
| Last Update Date | 07/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073825816 | NPI | - | NPPES |
| 1477790327 | Other | NM | CURRENT PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD2007-0072 (New Mexico) | Primary |
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