1346523719 NPI number — MRS. ADRIENNE RENEE GARCIA ACNP

Table of content: MRS. ADRIENNE RENEE GARCIA ACNP (NPI 1346523719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346523719 NPI number — MRS. ADRIENNE RENEE GARCIA ACNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
ADRIENNE
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ACNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346523719
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7909 FREDERICKSBURG RD
Provider Second Line Business Mailing Address:
SUITE # 110
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229-3425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-4544
Provider Business Mailing Address Fax Number:
210-679-3724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12709 TOEPPERWEIN RD
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
LIVE OAK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78233-3258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-564-8000
Provider Business Practice Location Address Fax Number:
210-679-3732
Provider Enumeration Date:
09/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  720216 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com