Provider Demographics
NPI:1659388973
Name:GARCIA, DAVID K (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 PRINCETON DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2628
Mailing Address - Country:US
Mailing Address - Phone:505-254-3617
Mailing Address - Fax:
Practice Address - Street 1:7920 CARMEL AVE NE
Practice Address - Street 2:SUITE 3
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-2966
Practice Address - Country:US
Practice Address - Phone:505-344-4959
Practice Address - Fax:505-341-0426
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2611174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2611OtherPT LICENSE #