Provider Demographics
NPI:1689844433
Name:GARZA-REY, LUKE LEE
Entity Type:Individual
Prefix:MR
First Name:LUKE
Middle Name:LEE
Last Name:GARZA-REY
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:LUKE
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 11867
Mailing Address - Street 2:CORRECTIONAL HEALTH
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93775-1867
Mailing Address - Country:US
Mailing Address - Phone:559-600-3229
Mailing Address - Fax:559-445-2772
Practice Address - Street 1:1225 M STREET
Practice Address - Street 2:CORRECTIONAL HEALTH, 2ND FLOOR
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1805
Practice Address - Country:US
Practice Address - Phone:559-442-2404
Practice Address - Fax:559-442-5277
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33430167G00000X
CAPT33430167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician