Provider Demographics
NPI:1457399347
Name:TERESA ARIZAGA-MORALES, M.D., P.C.
Entity type:Organization
Organization Name:TERESA ARIZAGA-MORALES, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ARIZAGA-MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-388-2743
Mailing Address - Street 1:3060 HIGHWAY 180 E
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7703
Mailing Address - Country:US
Mailing Address - Phone:575-388-8274
Mailing Address - Fax:575-388-8885
Practice Address - Street 1:3060 HIGHWAY 180 E
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7703
Practice Address - Country:US
Practice Address - Phone:575-388-2743
Practice Address - Fax:575-388-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-00672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM08807558Medicaid