Provider Demographics
NPI:1275075178
Name:GARCIA, MARIA (TXLAC, MS)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:TXLAC, MS
Other - Prefix:MS
Other - First Name:KIT
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TXLAC, MS
Mailing Address - Street 1:3913 TODD LN STE 107
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-1091
Mailing Address - Country:US
Mailing Address - Phone:512-619-4585
Mailing Address - Fax:
Practice Address - Street 1:3913 TODD LN STE 107
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-1091
Practice Address - Country:US
Practice Address - Phone:512-619-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00649171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist