Basic Information
| Provider Information | |||||||||
| NPI: | 1386871218 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW MEXICO EM-I MEDICAL SERVICES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 S PALAFOX ST | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325025960 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 42121 US HWY 70 | ||||||||
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| City: | PORTALES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 881300868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753591800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2009 | ||||||||
| LastUpdateDate: | 01/07/2013 | ||||||||
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| AuthorizedOfficialLastName: | BYRNE, MD | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8004447009 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.