Provider Demographics
NPI:1245559400
Name:MOYA, MONICA HILDA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:HILDA
Last Name:MOYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:385 CALLE DE ALEGRA
Mailing Address - Street 2:BLDG A
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3417
Mailing Address - Country:US
Mailing Address - Phone:575-526-1105
Mailing Address - Fax:
Practice Address - Street 1:575 S ALAMEDA BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2818
Practice Address - Country:US
Practice Address - Phone:575-528-6400
Practice Address - Fax:575-521-7199
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2013-0070207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM315509YRNDOtherMEDICARE
NM41408730Medicaid