1689844433 NPI number — MR. LUKE LEE GARZA-REY

Table of content: DR. TAMARA M. HAMMONS PHARM.D., CDE (NPI 1376576041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689844433 NPI number — MR. LUKE LEE GARZA-REY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARZA-REY
Provider First Name:
LUKE
Provider Middle Name:
LEE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARZA
Provider Other First Name:
LUKE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689844433
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 11867
Provider Second Line Business Mailing Address:
CORRECTIONAL HEALTH
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93775-1867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-600-3229
Provider Business Mailing Address Fax Number:
559-445-2772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1225 M STREET
Provider Second Line Business Practice Location Address:
CORRECTIONAL HEALTH, 2ND FLOOR
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93721-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-442-2404
Provider Business Practice Location Address Fax Number:
559-442-5277
Provider Enumeration Date:
03/07/2008

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: 167G00000X , with the licence number:  33430 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 167G00000X , with the licence number: PT33430 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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