| Sonoran Vein & Endovascular, Llc | |
|
1551 S Second St Gallup NM 87301-5881 | |
| (505) 542-0090 | |
| (505) 542-0155 |
| Full Name | Sonoran Vein & Endovascular, Llc |
|---|---|
| Speciality | Surgery |
| Location | 1551 S Second St, Gallup, New Mexico |
| Authorized Official Name and Position | David Nye (OWNER) |
| Authorized Official Contact | 4803637778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sonoran Vein & Endovascular, Llc 2487 S Gilbert Rd Ste 106-431 Gilbert AZ 85295-2825 Ph: (480) 363-7778 | Sonoran Vein & Endovascular, Llc 1551 S Second St Gallup NM 87301-5881 Ph: (505) 542-0090 |
| NPI Number | 1508574724 |
|---|---|
| Provider Enumeration Date | 11/07/2022 |
| Last Update Date | 01/11/2023 |
| Medicare PECOS PAC ID | 5991177016 |
|---|---|
| Medicare Enrollment ID | O20230217000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508574724 | NPI | - | NPPES |
| Provider Name | David James Nye |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1558623793 PECOS PAC ID: 6800030024 Enrollment ID: I20220926002521 |
| Provider Name | Claudia Macias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508496167 PECOS PAC ID: 3577992916 Enrollment ID: I20230320000226 |
| Provider Name | Jennifer E Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326313222 PECOS PAC ID: 6800059759 Enrollment ID: I20230321001566 |
| Provider Name | Joseph L Eliason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043977721 PECOS PAC ID: 9638535529 Enrollment ID: I20230518002943 |
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