Provider Demographics
NPI:1043549934
Name:QUALITY PEDIATRICS
Entity type:Organization
Organization Name:QUALITY PEDIATRICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-392-0120
Mailing Address - Street 1:3305 N GRIMES ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-1219
Mailing Address - Country:US
Mailing Address - Phone:575-392-0120
Mailing Address - Fax:575-392-0122
Practice Address - Street 1:3305 N GRIMES
Practice Address - Street 2:COMPLEX 2 SUITE 11
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9100
Practice Address - Country:US
Practice Address - Phone:575-392-0120
Practice Address - Fax:575-392-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2014-0535207W00000X
NMMD20050658261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty