De Baca Family Practice Clinic
De Baca Family Practice Clinic is a Federally Qualified Health Center (FQHC) in Fort Sumner, New Mexico. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
546 N 10th StFort Sumner, NM 88119
Phone: (575) 355-2414
Fax: (575) 355-7894
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X |
|---|
Record details
| NPI number | 1114737483 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | De Baca Family Practice Clinic |
| Authorized official | Lisa Walraven — Ceo · (575) 355-2420 |
| Other names | De Baca Family Practice Clinic/Mobile Unit |
| NPI enumerated | January 9, 2025 |
| Last updated in NPPES | October 14, 2025 |
| Certification date | October 14, 2025 |
| Mailing address | Po Box 349, Fort Sumner, NM 88119-0349 |
Other providers in Fort Sumner
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De Baca Family Practice Clinic
546 N Tenth St, Fort Sumner, NM 88119 · (505) 355-2414
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De Baca Family Practice Clinic
1001 Sumner Ave, Fort Sumner, NM 88119-0349 · (575) 355-4431