Eastern New Mexico University
NPI #1053794727 in Portales, New Mexico
Provider Information
- NPI Number
- 1053794727
- Entity Type
- Organization
- Organization Name
- Eastern New Mexico University
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jun 30, 2015
- Last Updated
- Jun 30, 2015
Practice Location
- Address
- 1500 S AVENUE K
- City
- Portales
- State
- New Mexico
- ZIP Code
- 88130-7400
- Phone
- (972) 367-4845
Authorized Official
- Name
- MOUZON BASS III
- Title
- AGENT
- Phone
- (972) 367-4845
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Sports Medicine — Sports Medicine |
| Family Medicine |
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