PANGEA MEDICAL LLC NPI 1457619934

NPI Information

NPI: 1457619934
Provider Name: PANGEA MEDICAL LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
2604 GAYE DR
ROSWELL, NM
ZIP 88201
Phone: (575) 578-4548
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PANGEA MEDICAL LLC is an adult mental health clinic center in Roswell, NM. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. PANGEA MEDICAL LLC NPI is 1457619934. The provider is registered as an organization entity type.

The provider's business location address is:

2604 GAYE DR
ROSWELL, NM
ZIP 88201-427
Phone: (575) 578-4548

The provider's authorized official is Steven Ray Black .
The authorized official title is M.d. and has the following contact phone number (575) 578-4548.

The enumeration date for this NPI number is 5/2/2012 and was last updated on 5/2/2012.

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	261QP2300X	Clinic/Center	Primary Care	MD2011-0547	NEW MEXICO	No
2	261QM0850X	Clinic/Center	Adult Mental Health	MD2011-0547	NEW MEXICO	Yes

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: 4/28/2024

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