Louis A Pena, | |
530 Demoss St., Lordsburg, NM 88045-2618 | |
(575) 542-2313 | |
Not Available |
Full Name | Louis A Pena |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 530 Demoss St., Lordsburg, New Mexico |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952793465 | NPI | - | NPPES |
23451246 | Medicaid | NM | |
520681KYWY | Other | NM | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | MD2016-0288 (New Mexico) | Primary |
291U00000X | Clinical Medical Laboratory | G72343 (California) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Louis A Pena, 530 Demoss St., Lordsburg, NM 88045-2618 Ph: (575) 542-2313 | Louis A Pena, 530 Demoss St., Lordsburg, NM 88045-2618 Ph: (575) 542-2313 |
News Archive
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