Basic Information
| Provider Information | |||||||||
| NPI: | 1154757334 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NELLY I. GARCIA DO PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 SURFSIDE BLVD | ||||||||
| Address2: | APT 203 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784021400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617930026 | ||||||||
| FaxNumber: | 7138501327 | ||||||||
| Practice Location | |||||||||
| Address1: | 2606 HOSPITAL BLVD | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784051833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619024000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2013 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | GARCIA | ||||||||
| AuthorizedOfficialFirstName: | NELLY | ||||||||
| AuthorizedOfficialMiddleName: | I. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3617930026 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | N8653 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
No ID Information.