1144467549 NPI number — MRS. SANDRA LUZ GARCIA-SALCIDO LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144467549 NPI number — MRS. SANDRA LUZ GARCIA-SALCIDO LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA-SALCIDO
Provider First Name:
SANDRA
Provider Middle Name:
LUZ
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARCIA
Provider Other First Name:
SANDRA
Provider Other Middle Name:
LUZ
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.P.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144467549
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3113 CRAZY HORSE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79936-2535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-740-6294
Provider Business Mailing Address Fax Number:
877-606-9254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9440 VISCOUNT BLVD
Provider Second Line Business Practice Location Address:
SUITE 117
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79925-7049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-740-6294
Provider Business Practice Location Address Fax Number:
877-606-9254
Provider Enumeration Date:
01/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  64611 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9647LC . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 197678903 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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