Provider Demographics
NPI:1821161407
Name:FAMILYCARE ASSOCIATES,PA
Entity Type:Organization
Organization Name:FAMILYCARE ASSOCIATES,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONCHITA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-525-4000
Mailing Address - Street 1:1135 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2946
Mailing Address - Country:US
Mailing Address - Phone:505-525-4000
Mailing Address - Fax:505-525-4040
Practice Address - Street 1:1135 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2946
Practice Address - Country:US
Practice Address - Phone:505-525-4000
Practice Address - Fax:505-525-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ2641Medicaid