Provider Demographics
NPI:1003006040
Name:NEW MEXICO SURGICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:NEW MEXICO SURGICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-843-7901
Mailing Address - Street 1:711 ENCINO PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102
Mailing Address - Country:US
Mailing Address - Phone:505-843-7901
Mailing Address - Fax:505-843-6384
Practice Address - Street 1:711 ENCINO PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2619
Practice Address - Country:US
Practice Address - Phone:505-843-7901
Practice Address - Fax:505-843-6384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000S9673Medicaid
NMCI6639OtherPALMETTORAILROADMEDICARE
NM000S9673Medicaid