Provider Demographics
NPI:1851566103
Name:GARCIA, FHEB G (PT)
Entity Type:Individual
Prefix:
First Name:FHEB
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 1ST ST STE 527
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4676
Mailing Address - Country:US
Mailing Address - Phone:575-309-8389
Mailing Address - Fax:
Practice Address - Street 1:4701 N PRINCE ST STE 265
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-9722
Practice Address - Country:US
Practice Address - Phone:575-840-3879
Practice Address - Fax:866-337-2718
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3216225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMPT3216OtherPT LICENSE