Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 93-144 | NM |
NPI | 1043212632 |
---|---|
Provider Name | Dr. Ramon A Saavedra |
First Address | Las Cruces, NM 88011-0808 |
Second Address | Las Cruces, NM 88011-4776 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 24/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F6004 | (02) | NM |