Basic Information
| Provider Information | |||||||||
| NPI: | 1568436723 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRAMBILA | ||||||||
| FirstName: | ARTEMIO | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 YALE BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871315631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052720053 | ||||||||
| FaxNumber: | 5052720052 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 YALE BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871315631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052720053 | ||||||||
| FaxNumber: | 5052720052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 04/26/2012 | ||||||||
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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 | 103T00000X | 481 | NM | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.