Provider Demographics
NPI:1932200904
Name:ALAS, EDUARDO A (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:A
Last Name:ALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 ENCINO PLACE N.E.
Mailing Address - Street 2:SUITE 26
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102
Mailing Address - Country:US
Mailing Address - Phone:505-884-4545
Mailing Address - Fax:505-884-4114
Practice Address - Street 1:717 ENCINO PLACE N.E.
Practice Address - Street 2:SUITE 26
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102
Practice Address - Country:US
Practice Address - Phone:505-884-4545
Practice Address - Fax:505-884-4114
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD20050840207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMI65556Medicare UPIN