| Dr Osvelia G Deeds Llc | |
|
5203 Juan Tabo Blvd Ne Ste 2b Albuquerque NM 87111-2691 | |
| (505) 850-5314 | |
| (505) 221-5710 |
| Full Name | Dr Osvelia G Deeds Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5203 Juan Tabo Blvd Ne Ste 2b, Albuquerque, New Mexico |
| Authorized Official Name and Position | Dawn Halfacre (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5053525269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Osvelia G Deeds Llc 1542 Rosalba St Ne Albuquerque NM 87112-6552 Ph: (505) 850-5314 | Dr Osvelia G Deeds Llc 5203 Juan Tabo Blvd Ne Ste 2b Albuquerque NM 87111-2691 Ph: (505) 850-5314 |
| NPI Number | 1912275124 |
|---|---|
| Provider Enumeration Date | 12/02/2011 |
| Last Update Date | 12/02/2011 |
| Medicare PECOS PAC ID | 5799952578 |
|---|---|
| Medicare Enrollment ID | O20120119000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912275124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1095 (New Mexico) | Primary |
| Provider Name | Osvelia G Deeds |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306171723 PECOS PAC ID: 2264562784 Enrollment ID: I20100610000213 |
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