Provider Demographics
NPI:1124398029
Name:GARCIA, LAURA BETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BETH
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117475
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-7475
Mailing Address - Country:US
Mailing Address - Phone:210-495-7246
Mailing Address - Fax:210-495-7245
Practice Address - Street 1:5000 SCHERTZ PKWY
Practice Address - Street 2:STE 400
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-495-7246
Practice Address - Fax:210-495-7245
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364759601Medicaid
TXB156667Medicare PIN