Provider Demographics
NPI:1346259991
Name:GARCIA, ELVIRA (MD)
Entity Type:Individual
Prefix:
First Name:ELVIRA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 GATHRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-3606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6250 REGIONAL PLZ
Practice Address - Street 2:SUITE 1030
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5262
Practice Address - Country:US
Practice Address - Phone:325-692-2777
Practice Address - Fax:325-695-0625
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2937208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126322001Medicaid