Provider Demographics
NPI:1184501694
Name:STROUD, GARRETT DANIEL (RPH)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:DANIEL
Last Name:STROUD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 PASEO DEL PUEBLO SUR
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6413
Mailing Address - Country:US
Mailing Address - Phone:575-758-3711
Mailing Address - Fax:
Practice Address - Street 1:224 PASEO DEL PUEBLO SUR
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6413
Practice Address - Country:US
Practice Address - Phone:575-758-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00010372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist