Provider Demographics
NPI:1033108972
Name:RIGALES, LUIS III (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:RIGALES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE B-104
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7672
Mailing Address - Country:US
Mailing Address - Phone:505-913-3450
Mailing Address - Fax:505-913-3451
Practice Address - Street 1:435 SAINT MICHAELS DR
Practice Address - Street 2:SUITE B-104
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7672
Practice Address - Country:US
Practice Address - Phone:505-913-3450
Practice Address - Fax:505-913-3451
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2001291207Q00000X
NM2001-291207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMG7205Medicaid
NM341313301Medicare ID - Type Unspecified
NMH45779Medicare UPIN