Healthcare Provider Details

I. General information

NPI: 1275071086
Provider Name (Legal Business Name): GARCIA SLOAN CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2017
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SUN AVE NE STE 650
ALBUQUERQUE NM
87109-4670
US

IV. Provider business mailing address

PO BOX 80214
ALBUQUERQUE NM
87198-0214
US

V. Phone/Fax

Practice location:
  • Phone: 505-859-4123
  • Fax: 866-881-5131
Mailing address:
  • Phone: 505-859-4123
  • Fax: 866-881-5131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number20020259
License Number StateNM

VIII. Authorized Official

Name: DR. AMY GARCIA
Title or Position: OWNER
Credential: MD
Phone: 505-859-4123