Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

San Miguel Clinic Corp

Organization Family Medicine Physician · NPI 1114920717

San Miguel Clinic Corp provides Family Medicine Physician services in Las Vegas, New Mexico. Registered with an NPI since 2005.

In the registry since
2005
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

108 Legion Dr Ste A
Las Vegas, NM 87701-4898
Phone: (505) 454-9499
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1114920717
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Laura Fey — Director Revenue Cycle · (615) 221-3641
NPI enumeratedMay 27, 2005
Last updated in NPPESOctober 17, 2023
Certification dateOctober 17, 2023
Mailing addressPo Box 5009, Brentwood, TN 37024-5009

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