Provider Demographics
NPI:1164700571
Name:TRES RIOS ANESTHESIOLOGY LLC
Entity Type:Organization
Organization Name:TRES RIOS ANESTHESIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-326-7246
Mailing Address - Street 1:4801 N BUTLER AVE
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6002
Mailing Address - Country:US
Mailing Address - Phone:505-326-7246
Mailing Address - Fax:505-592-0063
Practice Address - Street 1:4801 N BUTLER AVE
Practice Address - Street 2:SUITE 5000
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6002
Practice Address - Country:US
Practice Address - Phone:505-326-7246
Practice Address - Fax:505-592-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2010-0239207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty