Provider Demographics
NPI:1114645926
Name:GARCIA, ALEXIS RENEE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RENEE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 WINDY RIDGE PKWY SE # 825S
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5665
Mailing Address - Country:US
Mailing Address - Phone:678-708-2360
Mailing Address - Fax:
Practice Address - Street 1:1001 W BRAKER LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4114
Practice Address - Country:US
Practice Address - Phone:512-841-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist