Basic Information
| Provider Information | |||||||||
| NPI: | 1033108972 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGALES | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 435 SAINT MICHAELS DR | ||||||||
| Address2: | SUITE B-104 | ||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875057672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059133450 | ||||||||
| FaxNumber: | 5059133451 | ||||||||
| Practice Location | |||||||||
| Address1: | 435 SAINT MICHAELS DR | ||||||||
| Address2: | SUITE B-104 | ||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875057672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059133450 | ||||||||
| FaxNumber: | 5059133451 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 05/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2001291 | NM | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 2001-291 | NM | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | G7205 | 05 | NM | MEDICAID |