Angel Fire Primary Care

NPI #1053672485 in Red River, New Mexico

Provider Information

NPI Number: 1053672485
Entity Type: Organization
Organization Name: Angel Fire Primary Care
Primary Specialty: General Practice
Enumeration Date: Jun 1, 2012
Last Updated: Jun 1, 2012

Practice Location

Address: 200 A PIONEER ROAD
City: Red River
State: New Mexico
ZIP Code: 87558-0000
Phone: (575) 754-1773

Authorized Official

Name: DR. LESA D FRAKER, MD
Title: PRESIDENT
Phone: (505) 989-8707

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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