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 is a Family Medicine Physician 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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