Provider Demographics
NPI:1346725819
Name:GARCIA, MARISA ROCHA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:ROCHA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:
Other - Last Name:ROCHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:6835 AUSTIN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3189
Practice Address - Country:US
Practice Address - Phone:512-346-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139060363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27851OtherPRESCRIPTIVE AUTHORITY
TX821098OtherTEXAS RN LICENSE
TXAP139060OtherAPRN, FNP
F09180567OtherAANP FNP CERTIFICATION