Provider Demographics
NPI:1861486201
Name:CAGLIA, ANGELICA A (MD)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:A
Last Name:CAGLIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1560
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-1560
Mailing Address - Country:US
Mailing Address - Phone:505-647-8366
Mailing Address - Fax:505-647-8381
Practice Address - Street 1:1180 MALL DR
Practice Address - Street 2:SUITE C
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8101
Practice Address - Country:US
Practice Address - Phone:505-532-5500
Practice Address - Fax:505-532-1128
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM9045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2527Medicaid
NMNM009440OtherBC/BS
NM12087OtherPRESBYTERIAN
NM110225833OtherRR MEDICARE
NM88011A002OtherWPS TRICARE
E70017Medicare UPIN
NM88011A002OtherWPS TRICARE