Organization · Type 2 NPI

La Clinica de Familia, Incorporated

Federally Qualified Health Center (FQHC) · Chaparral, NM

NPI number 1871889337 Active

Practice location

510 E Lisa Dr, Bldg. 3
Chaparral, NM 88081-7809

Call (575) 824-0128 Map

Fax (575) 824-0179

Mailing address

385 Calle De Alegra, Bldg. A
Las Cruces, NM 88005-3423

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

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NPI record

NPI: 1871889337
Entity type: Organization (Type 2)
Issued: Jun 23, 2011
Last updated: May 13, 2021
Status: Active

Other names

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La Clinica de Familia Chaparral Dental · doing business as
La Clinica de Familia Chaparral Dental · doing business as

Authorized official

Virgil Medina
Chief Executive Officer
(575) 526-1105

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1871889337

La Clinica de Familia, Incorporated's National Provider Identifier is 1871889337, issued on Jun 23, 2011. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Chaparral, NM. The record was last updated on May 13, 2021.