SOUTHWEST PSYCHIATRY PLLC NPI 1427616259

NPI Information

NPI: 1427616259
Provider Name: SOUTHWEST PSYCHIATRY PLLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 45D1064997

Address:
5805 MCNUTT RD
SANTA TERESA, NM
ZIP 88008
Phone: (915) 244-4966
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SOUTHWEST PSYCHIATRY PLLC is a psychiatric/mental health nurse practitioner in Santa Teresa, NM. SOUTHWEST PSYCHIATRY PLLC NPI is 1427616259. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5805 MCNUTT RD
SANTA TERESA, NM
ZIP 88008-001
Phone: (915) 244-4966

The provider's authorized official is Daniel Bustillos .
The authorized official title is Pmhnp and has the following contact phone number (915) 244-4966.

The CLIA number assigned to this NPI record is 45D1064997 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2019 and was last updated on 6/5/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AP55389	OTHER	NEW MEXICO	LICENSE NUMBER
2	AP140763	OTHER	TEXAS	TEXAS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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