Healthcare Provider Details

I. General information

NPI: 1760497440
Provider Name (Legal Business Name): THOMAS L. GIVLER DSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 01/25/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4273 MONTGOMERY BLVD NE SUITE 260 E
ALBUQUERQUE NM
87109-6748
US

IV. Provider business mailing address

4273 MONTGOMERY BLVD NE SUITE 260 E
ALBUQUERQUE NM
87109-6748
US

V. Phone/Fax

Practice location:
  • Phone: 505-830-9307
  • Fax: 505-830-9307
Mailing address:
  • Phone: 505-830-9307
  • Fax: 505-830-9307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-0069
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: