Healthcare Provider Details

I. General information

NPI: 1750203139
Provider Name (Legal Business Name): LUIS FERNANDO GARZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SCENIC DR
ALAMOGORDO NM
88310-4340
US

IV. Provider business mailing address

9001 TAMMY CT
EL PASO TX
79904-1603
US

V. Phone/Fax

Practice location:
  • Phone: 915-867-9206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-0992
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: