Provider Demographics
NPI:1639476591
Name:BACHIR DEBBA MD LLC
Entity Type:Organization
Organization Name:BACHIR DEBBA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BACHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-521-3388
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:MESILLA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88047-0009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1505 S DON ROSER DR
Practice Address - Street 2:SUITE A
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4596
Practice Address - Country:US
Practice Address - Phone:575-521-3388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty