Basic Information
| Provider Information | |||||||||
| NPI: | 1457399347 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TERESA ARIZAGA-MORALES, M.D., P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3060 HIGHWAY 180 E | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880617703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753888274 | ||||||||
| FaxNumber: | 5753888885 | ||||||||
| Practice Location | |||||||||
| Address1: | 3060 HIGHWAY 180 E | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880617703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753882743 | ||||||||
| FaxNumber: | 5753888885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 03/13/2008 | ||||||||
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| AuthorizedOfficialLastName: | ARIZAGA-MORALES | ||||||||
| AuthorizedOfficialFirstName: | ANA | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5753882743 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD2005-0067 | NM | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 08807558 | 05 | NM | MEDICAID |