Provider Demographics
NPI:1427442458
Name:TAOS URGENT CARE, INC
Entity type:Organization
Organization Name:TAOS URGENT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-690-9872
Mailing Address - Street 1:204 BENDIX DR.
Mailing Address - Street 2:UNIT G
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-5241
Mailing Address - Country:US
Mailing Address - Phone:505-690-9872
Mailing Address - Fax:575-758-1474
Practice Address - Street 1:330 PASEO DEL PUEBLO SUR
Practice Address - Street 2:SUITE C
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5328
Practice Address - Country:US
Practice Address - Phone:575-758-1414
Practice Address - Fax:575-758-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM31501541Medicaid