Individual
DR. WALLACY SOUZA GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3670 PARKER BLVD., STE 101, PUEBLO, CO 81008-2285
(719) 564-1544
(719) 924-1592
Mailing address
PO BOX 560825, DENVER, CO 80256-0825
(719) 595-7580
(719) 545-0176
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
DR.0056470
CO
207RC0000X
Cardiovascular Disease Physician
P77521
NY
Other
Enumeration date
07/27/2011
Last updated
09/02/2016
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