Provider Demographics
NPI:1447293105
Name:SIERRA FAMILY HEALTHCARE, PC
Entity type:Organization
Organization Name:SIERRA FAMILY HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TORREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-532-7000
Mailing Address - Street 1:205 W. BOUTZ RD. BLDG #1
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005
Mailing Address - Country:US
Mailing Address - Phone:505-532-7000
Mailing Address - Fax:
Practice Address - Street 1:2903 HILLRISE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:505-532-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM12024074Medicaid