Provider Demographics
NPI:1194213181
Name:TERRAZAS, ALEX FRANCO (LMT)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:FRANCO
Last Name:TERRAZAS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 GALISTEO ST STE H2
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2106
Mailing Address - Country:US
Mailing Address - Phone:505-557-6140
Mailing Address - Fax:
Practice Address - Street 1:2019 GALISTEO ST STE H2
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2106
Practice Address - Country:US
Practice Address - Phone:505-557-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM7175225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty