LA CLINICA DE FAMILIA, INCORPORATED (NPI# 1730152281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730152281 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DE FAMILIA, INCORPORATED |
| Other Organization Name | LA CLINICA DE FAMILIA SUNLAND PARK |
| Practice Address |
2625 Mcnutt Rd Sunland Park NM 88063-9019 |
| Mailing Address |
385 Calle De Alegra Bldg. A Las Cruces NM 88005-3423 |
| Practice Telephone | 5755890887 |
| Practice Fax Number | 5755890898 |
| Mailing Telephone | 5755261105 |
| Mailing Fax Number | 5755244266 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-06-01 |
| Authorized Official Name | VIRGIL MEDINA (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5755261105 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 47552 | 05 |
| Other Name | Type Code |
|---|---|
| La Clinica De Familia Sunland Park | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2625 Mcnutt Rd Ste B, Sunland Park, NM 880639608 | 5755890887 | 5755890898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902436702 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr Bldg 2, Chaparral, NM 88081-7809 | 2020-01-21 |
| 1508838004 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr, Chaparral, NM 88081-7809 | 2006-02-07 |
| 1962047506 | La Clinica De Familia, Incorporated | Clinic/Center | 2625 Mcnutt Rd Ste B, Sunland Park, NM 88063-9608 | 2019-11-07 |
| 1255711255 | La Clinica De Familia, Incorporated | Foster Care Agency | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-04 |
| 1033599022 | La Clinica De Familia, Incorporated | Clinic/Center | 826 Anthony Dr., Anthony, NM 88021-9346 | 2015-06-04 |
| 1073993200 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-03 |
| 1639559891 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-03 |
| 1164802310 | La Clinica De Familia, Incorporated | Clinic/Center | 105 W Griggs Ave, Las Cruces, NM 88001 | 2015-06-03 |
| 1871973297 | La Clinica De Familia, Incorporated | Clinic/Center | 100 W Griggs Ave, Las Cruces, NM 88001-1234 | 2015-06-01 |
| 1003087867 | La Clinica De Familia, Incorporated | Social Worker | 570 W Griggs Ave, Las Cruces, NM 88005-2604 | 2008-03-19 |
| Street Address |
2625 MCNUTT RD |
| City | SUNLAND PARK |
| State | NM |
| Zip Code | 88063-9019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669085650 | Horacio Favela Jr. | Dentist | 2625 Mcnutt Rd, Sunland Park, NM 88063-9608 | 2020-08-28 |
| 1801456058 | Crystal Morales | Case Manager/Care Coordinator | 2625 Mcnutt Rd, Sunland Park, NM 88063-9608 | 2019-06-19 |
| 1457711434 | Kerima B Setra | Dental Hygienist | 2625 Mcnutt Rd, Sunland Park, NM 88063-0940 | 2016-03-03 |
| 1881065944 | Srikanthi Saladi | Dentist | 2625 Mcnutt Rd, Sunland Park, NM 88063 | 2015-10-15 |
| 1841673951 | Rajan Gupta | Dentist | 2625 Mcnutt Rd, Sunland Park, NM 88063-9019 | 2015-07-07 |
| 1609260496 | Sandra Ceniceros | Dental Hygienist | 2625 Mcnutt Rd, Sunland Park, NM 88063-9019 | 2015-03-19 |
| 1497162929 | Leticia Castillo | Social Worker | 2625 Mcnutt Rd, Sunland Park, NM 88063 | 2014-07-16 |
| 1477968246 | Anne Roberti | Family Medicine | 2625 Mcnutt Rd, Sunland Park, NM 88063 | 2014-06-30 |
| 1922449560 | Sucharitha Meka | Family Medicine | 2625 Mcnutt Rd, Sunland Park, NM 88063 | 2013-07-11 |
| 1770874927 | Samyuktha Reddy Duvurri | Dentist | 2625 Mcnutt Rd, Sunland Park, NM 88063-9019 | 2011-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962801258 | Kristina Sutton | Speech-Language Pathologist | 4950 Mcnut Road, Sunland Park, NM 88063 | 2014-08-22 |
| 1609147313 | Sonia Maldonado | Counselor | 101 Maguey Court, Suite 1, Sunland Park, NM 88063 | 2012-01-26 |
| 1902027501 | Marsha Brand | Speech-Language Pathologist | 4950 Mcnutt Road, Sunland Park, NM 88063 | 2007-05-01 |
| 1114143393 | Gadsden Independent School District | Local Education Agency (LEA) | 4950 Mcnutt Rd, Sunland Park, NM 88063 | 2007-04-17 |
| 1275658254 | Irma Carrasco | Specialist | 4950 Mc Nutt Rd, Anthony, NM 88063 | 2007-03-20 |
| 1861745572 | Juliana Moran | Speech-Language Pathologist | 4950 Mcnutt Rd, Santa Teresa, NM 88063 | 2012-10-18 |
| 1831461243 | Maria Lourdes Torres | Community Health Worker | 3465 Mcnutt Rd, Sunland Park, NM 88063 | 2012-01-31 |
| 1447490248 | Jeanette Edwards | Psychologist | 4950 Mcnutt Rd, Santa Teresa, NM 88063 | 2009-03-06 |
| 1427235886 | Berenice Holguin | Social Worker | 4950 Mcnutt Rd, Sunland Park, NM 88063 | 2008-01-29 |
| 1396922746 | Ivette Acevedo | Occupational Therapist | 4950 Mcnutt Rd, Sunland Park, NM 88063 | 2008-01-29 |
| Find all providers in zip 88063 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962047506 | La Clinica De Familia, Incorporated | Clinic/Center | 2625 Mcnutt Rd Ste B, Sunland Park, NM 88063-9608 | 2019-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265666 | Hidalgo Medical Services | Clinic/Center | 105 1/2 N East St., Santa Clara, NM 88026 | 2020-08-12 |
| 1902436702 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr Bldg 2, Chaparral, NM 88081-7809 | 2020-01-21 |
| 1114578671 | La Clinica De Familia, Inc. | Clinic/Center | 100 Shrode Rd, Anthony, NM 88021-7350 | 2019-09-26 |
| 1083262422 | Presbyterian Medical Services | Clinic/Center | 28 Panther Parkway, 63 North Highway, Pecos, NM 87552 | 2019-08-29 |
| 1669930392 | El Centro Family Health | Clinic/Center | 1401 8th Street, Springer, NM 87747 | 2019-03-12 |
| 1487119608 | Presbyterian Medical Services | Clinic/Center | 1 Salomon Griego Road, Veguita, NM 87062 | 2019-02-01 |
| 1417440777 | Las Clinicas Del Norte Incorporated | Clinic/Center | 1797b St. Rd 502, Santa Fe, NM 87506 | 2018-06-12 |
| 1467971986 | Hidalgo Medical Services | Clinic/Center | 3200 32nd St Bypass, Silver City, NM 88061 | 2017-09-15 |
| 1417472192 | Fnch Outpatient Services | Clinic/Center | 634 Manzano Street Ne, Albuquerque, NM 87110 | 2017-08-03 |
| 1689034662 | La Clinica De Familia, Inc. | Clinic/Center | 6301 Nm Highway 28, Anthony, NM 88021 | 2016-03-03 |
| Find all providers with the same taxonomy | ||||
| City | SUNLAND PARK |
| Zip Code | 88063 |
Please comment or provide details below to improve the information on LA CLINICA DE FAMILIA, INCORPORATED.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.