| Neurology Associates Of Mesilla Valley Pc | |
|
3855 Foothills Drive Las Cruces NM 88011 | |
| (575) 532-8561 | |
| (575) 532-8567 |
| Full Name | Neurology Associates Of Mesilla Valley Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3855 Foothills Drive, Las Cruces, New Mexico |
| Authorized Official Name and Position | Javed Iqbal (OWNER/PRESIDENT) |
| Authorized Official Contact | 5755328561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Associates Of Mesilla Valley Pc 3855 Foothills Drive Las Cruces NM 88011 Ph: (575) 532-8561 | Neurology Associates Of Mesilla Valley Pc 3855 Foothills Drive Las Cruces NM 88011 Ph: (575) 532-8561 |
| NPI Number | 1760476139 |
|---|---|
| Provider Enumeration Date | 08/31/2005 |
| Last Update Date | 09/14/2021 |
| Certification Date | 09/14/2021 |
| Medicare PECOS PAC ID | 7214824721 |
|---|---|
| Medicare Enrollment ID | O20040301000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760476139 | NPI | - | NPPES |
| K1326 | Medicaid | NM | |
| F0584 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 92256 (New Mexico) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | K2499 (Texas) | Secondary |
| Provider Name | Javed Iqbal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235123605 PECOS PAC ID: 0648167163 Enrollment ID: I20050713000469 |
| Provider Name | Kerry Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174981690 PECOS PAC ID: 0648578534 Enrollment ID: I20160408001026 |
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