Healthcare Provider Details

I. General information

NPI: 1982429684
Provider Name (Legal Business Name): ARTURO GARCIA III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 03/01/2026
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 4TH ST NW STE 1
LOS RANCHOS NM
87107-5855
US

IV. Provider business mailing address

6303 4TH ST NW STE 1
LOS RANCHOS NM
87107-5855
US

V. Phone/Fax

Practice location:
  • Phone: 505-903-4413
  • Fax: 505-903-7183
Mailing address:
  • Phone: 505-903-4413
  • Fax: 505-903-7183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2025-0547
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: