NPI 1013436005

Ezekiel Mauricio

Practitioner Student in an Organized Health Care Education/Training Program Portales, NM

Practice location

Address: 1500 S Ave K Station 3, Shroc, Portales, NM 88130-8813
Phone: (361) 236-9006
Fax: (361) 236-9006
Mailing address: 1500 S Ave K Station 3, Shroc, Portales, NM 88130

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in New Mexico →

Registry record

NPI: 1013436005
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Sep 2017
Record last updated: 12 Sep 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.