Provider Demographics
NPI:1316136971
Name:FATIMA T. GARCES
Entity type:Organization
Organization Name:FATIMA T. GARCES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:TABAREZ
Authorized Official - Last Name:GARCES
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:915-241-7870
Mailing Address - Street 1:3216 STONE EDGE RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-2428
Mailing Address - Country:US
Mailing Address - Phone:915-241-7870
Mailing Address - Fax:
Practice Address - Street 1:3216 STONE EDGE RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-2428
Practice Address - Country:US
Practice Address - Phone:915-241-7870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06127133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
610297Medicare PIN