| Deer Oaks Southwest | |
|
1112 San Pedro Dr Ne Suite 222 Albuquerque NM 87110-6724 | |
| (505) 254-3505 | |
| (210) 593-9863 |
| Full Name | Deer Oaks Southwest |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1112 San Pedro Dr Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Paul Alan Boskind (CEO) |
| Authorized Official Contact | 2106153472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer Oaks Southwest 7272 Wurzbach Rd Suite 601 San Antonio TX 78240-4801 Ph: (210) 615-3472 | Deer Oaks Southwest 1112 San Pedro Dr Ne Suite 222 Albuquerque NM 87110-6724 Ph: (505) 254-3505 |
| NPI Number | 1831354620 |
|---|---|
| Provider Enumeration Date | 07/22/2008 |
| Last Update Date | 02/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831354620 | NPI | - | NPPES |
| 382270 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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