| Peter Sangra Md Llc | |
|
5055 Mcnutt Rd Santa Teresa NM 88008-9442 | |
| (575) 589-3000 | |
| Not Available |
| Full Name | Peter Sangra Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 5055 Mcnutt Rd, Santa Teresa, New Mexico |
| Authorized Official Name and Position | Peter Sangra (OWNER) |
| Authorized Official Contact | 4045132350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Sangra Md Llc 2004 Boy Scout Ln Sunland Park NM 88063-9500 Ph: (404) 513-2350 | Peter Sangra Md Llc 5055 Mcnutt Rd Santa Teresa NM 88008-9442 Ph: (575) 589-3000 |
| NPI Number | 1306464615 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 07/13/2020 |
| Certification Date | 07/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306464615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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