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

De Baca Family Practice Clinic

Organization Federally Qualified Health Center (FQHC) · NPI 1699082644

De Baca Family Practice Clinic is a Federally Qualified Health Center (FQHC) in Fort Sumner, New Mexico. Licensed in New Mexico. Registered with an NPI since 2010.

Licensed in
NM
In the registry since
2010

Practice location Address checks out

1001 Sumner Ave
Fort Sumner, NM 88119-0349
Phone: (575) 355-4431
Fax: (575) 355-4432
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X · Licence 3069 (NM)

Record details

NPI number1699082644
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationDe Baca Family Practice Clinic
Authorized official Lisa Walraven — Ceo · (575) 355-2420
Other names De Baca Family Practice Clinic/School Site
NPI enumeratedSeptember 10, 2010
Last updated in NPPESOctober 14, 2025
Certification dateOctober 14, 2025
Mailing addressPo Box 349, Fort Sumner, NM 88119-0349

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