Basic Information
Provider Information
NPI: 1467976530
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA-GARZA
FirstName: CARMEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSN, RN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 W ADOUE ST
Address2:  
City: ALVIN
State: TX
PostalCode: 775112718
CountryCode: US
TelephoneNumber: 2818241480
FaxNumber: 2812206407
Practice Location
Address1: 905 N GULF BLVD
Address2:  
City: FREEPORT
State: TX
PostalCode: 77541
CountryCode: US
TelephoneNumber: 2818241480
FaxNumber: 2812206407
Other Information
ProviderEnumerationDate: 07/31/2017
LastUpdateDate: 05/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP134717TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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