Provider Demographics
NPI:1952872640
Name:GARCIA, JOAQUIN REYES (RBT)
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:REYES
Last Name:GARCIA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MSC09 5030 1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-8244
Mailing Address - Fax:505-272-5821
Practice Address - Street 1:MSC09 5030 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-8244
Practice Address - Fax:505-272-5821
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2023-04-06
Deactivation Date:2023-03-28
Deactivation Code:
Reactivation Date:2023-04-06
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program