Provider Demographics
NPI:1073717237
Name:GARCIA DE MITCHELL, CECILIA ALEJANDRA (MD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:ALEJANDRA
Last Name:GARCIA DE MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:ALEJANDRA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4499 MEDICAL DR
Mailing Address - Street 2:SUITE 347
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3735
Mailing Address - Country:US
Mailing Address - Phone:210-615-0068
Mailing Address - Fax:210-615-0076
Practice Address - Street 1:4499 MEDICAL DR
Practice Address - Street 2:SUITE 347
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3735
Practice Address - Country:US
Practice Address - Phone:210-615-0068
Practice Address - Fax:210-615-0076
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1643208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery