Provider Demographics
NPI:1083328074
Name:CORDOVA GARCIA, YANIELKA (APRN)
Entity Type:Individual
Prefix:
First Name:YANIELKA
Middle Name:
Last Name:CORDOVA GARCIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22611 CREMONA VILLAGE TRL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2891
Mailing Address - Country:US
Mailing Address - Phone:346-970-9490
Mailing Address - Fax:
Practice Address - Street 1:22611 CREMONA VILLAGE TRL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2891
Practice Address - Country:US
Practice Address - Phone:346-970-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine