| La Familia Primary Care P C | |
|
190 Hospital Dr Raton NM 87740-2002 | |
| (575) 445-5563 | |
| (575) 445-5566 |
| Full Name | La Familia Primary Care P C |
|---|---|
| Speciality | Clinic/Center |
| Location | 190 Hospital Dr, Raton, New Mexico |
| Authorized Official Name and Position | Misbah D Zmily (OWNERPRESIDENT) |
| Authorized Official Contact | 5054455563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Familia Primary Care P C 190 Hospital Dr Raton NM 87740-2002 Ph: (575) 445-5563 | La Familia Primary Care P C 190 Hospital Dr Raton NM 87740-2002 Ph: (575) 445-5563 |
| NPI Number | 1366525537 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 11/23/2022 |
| Medicare PECOS PAC ID | 0446352207 |
|---|---|
| Medicare Enrollment ID | O20070226000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366525537 | NPI | - | NPPES |
| 56903 | Medicaid | NM | |
| 607623110P | Other | NM | R.R. MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 96-165 (New Mexico) | Primary |
| Provider Name | Misbah D Zmily |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285735332 PECOS PAC ID: 4183726722 Enrollment ID: I20070228000175 |
| Provider Name | Tamara S Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750787339 PECOS PAC ID: 7517283658 Enrollment ID: I20150306001685 |
| Provider Name | Amy C Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497840284 PECOS PAC ID: 7012072093 Enrollment ID: I20200813000571 |
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