Healthcare Provider Details

I. General information

NPI: 1821156795
Provider Name (Legal Business Name): UMBERTO I GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S. TELSHOR BLVD.
LAS CRUCES NM
88011
US

IV. Provider business mailing address

1200 S TELSHOR BLVD
LAS CRUCES NM
88011-4747
US

V. Phone/Fax

Practice location:
  • Phone: 505-521-7411
  • Fax: 505-521-7537
Mailing address:
  • Phone: 505-522-1814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNM81199
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: