Provider Demographics
NPI:1417434101
Name:GARCIA, SAMUEL (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14425 N LOOP DR SPC K
Mailing Address - Street 2:
Mailing Address - City:CLINT
Mailing Address - State:TX
Mailing Address - Zip Code:79836-5313
Mailing Address - Country:US
Mailing Address - Phone:915-790-7829
Mailing Address - Fax:
Practice Address - Street 1:14588 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:CLINT
Practice Address - State:TX
Practice Address - Zip Code:79836-6111
Practice Address - Country:US
Practice Address - Phone:915-790-7829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM56059363LF0000X
TXAP137837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily