Provider Demographics
NPI:1225279250
Name:GARCIA, CARLA M (DOM)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 EUBANK BLVD NE STE 105
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2565
Mailing Address - Country:US
Mailing Address - Phone:505-235-7026
Mailing Address - Fax:
Practice Address - Street 1:4550 EUBANK BLVD NE STE 105
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2565
Practice Address - Country:US
Practice Address - Phone:505-271-6608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-22
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM987171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist