Healthcare Provider Details

I. General information

NPI: 1548139256
Provider Name (Legal Business Name): LUCIA GARTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13020 ENRIQUE GOMEZ LN
EL PASO TX
79938-1213
US

IV. Provider business mailing address

13020 ENRIQUE GOMEZ LN
EL PASO TX
79938-1213
US

V. Phone/Fax

Practice location:
  • Phone: 915-238-3085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number150475
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: