Healthcare Provider Details

I. General information

NPI: 1750550463
Provider Name (Legal Business Name): GLORIA VERONICA GARZA MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN PEDRO SE NEW MEXICO VA HEALTH CARE SYSTEM
ALBUQUERQUE NM
87108
US

IV. Provider business mailing address

1501 SAN MATEO SE NEW MEXICO VA HEALTH CARE SYSTEM
ALBUQUERQUE NM
87108
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-1711
  • Fax:
Mailing address:
  • Phone: 505-265-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number290
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: