Provider Demographics
NPI:1306857966
Name:GARCIA-HOLGUIN, MARY HELEN (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HELEN
Last Name:GARCIA-HOLGUIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12050 VANCE JACKSON
Mailing Address - Street 2:BLDG 2 STE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230
Mailing Address - Country:US
Mailing Address - Phone:210-699-8881
Mailing Address - Fax:210-699-0503
Practice Address - Street 1:12050 VANCE JACKSON
Practice Address - Street 2:BLDG 2 STE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230
Practice Address - Country:US
Practice Address - Phone:210-699-8881
Practice Address - Fax:210-699-0503
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ33112084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116144003Medicaid
TXOOU57KMedicare ID - Type Unspecified