Healthcare Provider Details

I. General information

NPI: 1588529960
Provider Name (Legal Business Name): LUIS IRVIN CARBAJAL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 N MAIN ST
LAS CRUCES NM
88001-1162
US

IV. Provider business mailing address

12507 KARI ANNE DR
EL PASO TX
79928-1777
US

V. Phone/Fax

Practice location:
  • Phone: 575-525-0298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00010427
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: