Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | A-1903-15 | NM |
NPI | 1487977690 |
---|---|
Provider Name | Dr. Francisco Laboy III |
First Address | Las Cruces, NM 88011-8255 |
Second Address | Las Cruces, NM 88011-8255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2010 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
87530562 | (05) | NM |