MR. ALLEN MICHAEL FREY (NPI# 1629152764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629152764 |
| Entity Type | Individual |
| Full Name | MR. ALLEN MICHAEL FREY |
| Credential | R.T. |
| Practice Address |
Jicarilla Apache Health Care Center 12000 Stone Lake Road Dulce NM 87528 |
| Mailing Address |
Hc 75 Box 189 Chama NM 87520-9712 |
| Practice Telephone | 5057593291 |
| Mailing Telephone | 5057567219 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | MEDICARE PART B | HSZ196 | 01 |
| NM | 000K3526 | 05 |
| Street Address |
JICARILLA APACHE HEALTH CARE CENTER 12000 STONE LAKE ROAD |
| City | DULCE |
| State | NM |
| Zip Code | 87528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164917373 | Kelly Rae Pettigrew | Optometrist | 505 North Mundo, Dulce, NM 87528 | 2018-06-29 |
| 1780003442 | Jacob Alexander | Preventive Medicine | 500 N. Mundo, Dulce, NM 87528 | 2014-04-09 |
| 1881020089 | Jicarilla Apache Nation | Clinic/Center | 450 N Mundo Dr., Dulce, NM 87528 | 2013-09-19 |
| 1285971515 | Samuel Taylor Cropp | Pharmacist | 500 N Mundo Dr, Dulce, NM 87528 | 2013-01-07 |
| 1720331697 | Northwest Reional Education Coop #2 | Student in an Organized Health Care Education/Training Program | 91 Hawk Drive, Dulce, NM 87528 | 2012-10-17 |
| 1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
| 1669762043 | Veronica A Medlin | Technician, Pathology | 1200 Stone Lake Rd, Dulce, NM 87528 | 2011-04-19 |
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, Dulce, NM 87528 | 2011-04-19 |
| 1134419518 | Ray Morris Joe | Technician, Pathology | 500 North Mundo Road, Dulce, NM 87528 | 2011-04-19 |
| 1801186341 | Raquel Irene Cisneros | Family Medicine | 500 N. Mundo Dr., Dulce, NM 87528 | 2011-04-18 |
| Find all providers in zip 87528 | ||||
| Taxonomy Code | 2471C3402X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730259805 | New Mexico Sonographics Inc | Radiologic Technologist | 4600 A Montgomery Ne, Ste 105, Albuquerque, NM 87109-1292 | 2006-11-08 |
| 1861052177 | April Montano | Radiologic Technologist | 1804 June St Ne, Albuquerque, NM 87112-3146 | 2019-06-18 |
| 1023411741 | Anita Torrez | Radiologic Technologist | 311 Los Lentes Rd Se, Los Lunas, NM 87031-9224 | 2014-10-08 |
| 1871996595 | Johnny Ray Crain Jr. | Radiologic Technologist | 311 Los Lentes Rd Se, Los Lunas, NM 87031-9224 | 2014-10-08 |
| 1912257643 | Nicole G. Sers | Radiologic Technologist | 1515 Eubank Se, Albuquerque, NM 87123 | 2012-09-10 |
| 1871842955 | Toni Faye Kirby | Radiologic Technologist | 1515 Eubank Blvd Se Bldg. 831/832, Albuquerque, NM 87123 | 2012-09-05 |
| 1225386287 | Robert P Delao | Radiologic Technologist | 1515 Eubank Blvd Se, Bld. 831/832, Albuquerque, NM 87123-3453 | 2012-08-24 |
| 1255317111 | Melanie Faye Cruise | Radiologic Technologist | Us Hwy 491 North, Shiprock, NM 87420 | 2005-12-21 |
Please comment or provide details below to improve the information on MR. ALLEN MICHAEL FREY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.