Provider Demographics
NPI:1790423341
Name:TAFOYA, TOMAS (DPT)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:
Last Name:TAFOYA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7849 TRAMWAY BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-2529
Mailing Address - Country:US
Mailing Address - Phone:505-821-3831
Mailing Address - Fax:505-212-0786
Practice Address - Street 1:7849 TRAMWAY BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-2529
Practice Address - Country:US
Practice Address - Phone:505-821-3831
Practice Address - Fax:505-212-0786
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM59162251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM502856659OtherPASSPORT