Provider Demographics
NPI:1265434807
Name:SOUTHWEST HEALTHCARE ASSOCIATES LLC
Entity type:Organization
Organization Name:SOUTHWEST HEALTHCARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-647-8366
Mailing Address - Street 1:PO BOX 1560
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-1560
Mailing Address - Country:US
Mailing Address - Phone:575-647-8366
Mailing Address - Fax:575-647-8381
Practice Address - Street 1:780 S WALNUT ST
Practice Address - Street 2:BLDG #7
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1425
Practice Address - Country:US
Practice Address - Phone:575-527-2600
Practice Address - Fax:575-527-5342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM96164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMJ2106Medicaid
NM300521104Medicare PIN