Provider Demographics
NPI:1083703250
Name:HEALTHQUEST MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:HEALTHQUEST MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WIFE OF MD-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROMANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MGR
Authorized Official - Phone:575-642-6738
Mailing Address - Street 1:PO BOX 13148
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88013-3148
Mailing Address - Country:US
Mailing Address - Phone:575-642-6738
Mailing Address - Fax:575-541-1069
Practice Address - Street 1:1001 N SOLANO DR
Practice Address - Street 2:STE:A
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-2366
Practice Address - Country:US
Practice Address - Phone:575-522-4040
Practice Address - Fax:575-541-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty