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General NPI Number Information
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NPI Number | 1124700562
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Entity Type | Individual
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Provider Name | VICTORIA MAE GARCIA CDP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 43 BIG CHEIF RD
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City | ILFELD
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State | NM
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Zip | 87538
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Country | US
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Telephone | 505-469-7773
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Fax | 505-657-7733
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Provider Business Mailing Address
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Address Line | HC 73 BOX 549
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City | SAN JOSE
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State | NM
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Zip | 87565-9714
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Country | US
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Telephone | 505-469-7773
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Fax | 505-657-7733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number | 6888283
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License Number State | NM
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