La Clinica De Familia, Incorporated
NPI #1871889337 in Chaparral, New Mexico
Provider Information
- NPI Number
- 1871889337
- Entity Type
- Organization
- Organization Name
- La Clinica De Familia, Incorporated
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Jun 23, 2011
- Last Updated
- May 13, 2021
Practice Location
- Address
- 510 E LISA DR
- Address 2
- BLDG. 3
- City
- Chaparral
- State
- New Mexico
- ZIP Code
- 88081-7809
- Phone
- (575) 824-0128
Authorized Official
- Name
- VIRGIL MEDINA
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (575) 526-1105
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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