1588758973 NPI number — MS. DELIA D GARCIA RD

Table of content: MS. DELIA D GARCIA RD (NPI 1588758973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588758973 NPI number — MS. DELIA D GARCIA RD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
DELIA
Provider Middle Name:
D
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARPER
Provider Other First Name:
DELIA
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588758973
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 965
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCIADA
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87742-0965
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-923-5356
Provider Business Mailing Address Fax Number:
505-923-5654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1202 HIGHWAY 60
Provider Second Line Business Practice Location Address:
SOCORRO GENERAL HOSPITAL
Provider Business Practice Location Address City Name:
SOCORRO
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87801-3914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-835-8305
Provider Business Practice Location Address Fax Number:
575-835-8703
Provider Enumeration Date:
10/03/2006

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: 133V00000X , with the licence number:  496 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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