| Buena Salud Family Medicine, Llc | |
|
1900 Hot Springs Blvd Suite D Las Vegas NM 87701-3481 | |
| (505) 429-0137 | |
| Not Available |
| Full Name | Buena Salud Family Medicine, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1900 Hot Springs Blvd, Las Vegas, New Mexico |
| Authorized Official Name and Position | Frank Villanueva Gallegos (PHYSICIAN/OWNER) |
| Authorized Official Contact | 5054290137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buena Salud Family Medicine, Llc 1900 Hot Springs Blvd Suite D Las Vegas NM 87701-3481 Ph: () - | Buena Salud Family Medicine, Llc 1900 Hot Springs Blvd Suite D Las Vegas NM 87701-3481 Ph: (505) 429-0137 |
| NPI Number | 1336464429 |
|---|---|
| Provider Enumeration Date | 03/31/2010 |
| Last Update Date | 03/31/2010 |
| Medicare PECOS PAC ID | 5395877161 |
|---|---|
| Medicare Enrollment ID | O20100714000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336464429 | NPI | - | NPPES |
| 25551 | Medicaid | NM | |
| 1619960069 | Other | NM | PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 90-42 (New Mexico) | Primary |
| Provider Name | Frank V Gallegos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619960069 PECOS PAC ID: 6901907708 Enrollment ID: I20070724000260 |
| Provider Name | Olivia Kimble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356836647 PECOS PAC ID: 3173867272 Enrollment ID: I20181130000085 |
| Provider Name | Wende M Frybarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245797117 PECOS PAC ID: 4587990510 Enrollment ID: I20190729000934 |
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