Provider Demographics
NPI:1285483941
Name:SAMORA, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2669 SCENIC DR STE B
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-8734
Mailing Address - Country:US
Mailing Address - Phone:575-446-5687
Mailing Address - Fax:
Practice Address - Street 1:2669 SCENIC DR STE B
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-8734
Practice Address - Country:US
Practice Address - Phone:575-446-5687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker