Ezekiel Mauricio
Student in an Organized Health Care Education/Training Program in Portales, NM. Individual provider (NPI-1).
Details
- NPI
- 1013436005
- Entity type
- Individual (NPI-1)
- Name
- Ezekiel Mauricio
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 12, 2017
- Last updated
- Sep 12, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1500 S Ave KStation 3, Shroc
Portales, NM 88130-8813
Phone 361-236-9006 · Fax 361-236-9006
Mailing address
1500 S Ave KStation 3, Shroc
Portales, NM 88130
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 121 Student in an Organized Health Care Education/Training Program providers in Portales · All 423 providers in Portales
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