Provider Demographics
NPI:1245054857
Name:MERAZ FAMILY HEALTH LLC
Entity type:Organization
Organization Name:MERAZ FAMILY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MERAZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:575-800-7410
Mailing Address - Street 1:6507 CHUKAR CT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7084
Mailing Address - Country:US
Mailing Address - Phone:575-621-9689
Mailing Address - Fax:
Practice Address - Street 1:4131 CAMINO COYOTE STE C
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-3000
Practice Address - Country:US
Practice Address - Phone:575-800-7410
Practice Address - Fax:575-800-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty