Gregory Thomas Lyles-Davis | Albuquerque, NM • PECOS Search

Gregory Thomas Lyles-Davis

Case Manager/Care Coordinator

Other Service Providers

332 Jefferson St NE, Apt A, Albuquerque, NM 87108-1259

PECOS Enrollment

Based on the most recent information from CMS, provider Gregory Thomas Lyles-Davis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1326397068
Provider Type
Individual
Full Name
Lyles-Davis, Gregory Thomas
Title
Mr.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/7/2012
Last Updated
9/7/2012

Contact Information

Practice Location

332 Jefferson St NE, Apt A, Albuquerque, NM 87108-1259

Unlisted Fax

Mailing Location

332 Jefferson St NE, Apt A, Albuquerque, NM 87108-1259

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer