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NPI 1811957913

NPI 1811957913 : SANDRA MARIE GARCIA MD : GALLUP, NM

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General NPI Number Information
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    NPI Number           |    1811957913
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    Entity Type          |    Individual 
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    Provider Name        |    SANDRA MARIE GARCIA MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/24/2006
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    Last Update Date     |    02/28/2012
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Provider Practice Location Address
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    Address Line         |    516 E NIZHONI BLVD 
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    City                 |    GALLUP
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    State                |    NM
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    Zip                  |    87301-5748
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    Country              |    US
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    Telephone            |    505-722-1000
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    Fax                  |    505-722-1268
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1337 
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    City                 |    GALLUP
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    State                |    NM
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    Zip                  |    87305-1337
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    Country              |    US
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    Telephone            |    505-722-1000
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    Fax                  |    505-722-1310
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    DM106336
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    License Number State |    PR
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