Provider Demographics
NPI:1467771915
Name:GARCIA, BLANCA IVONNE
Entity Type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:IVONNE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12391 ORCHARD PARK
Mailing Address - Street 2:
Mailing Address - City:CLINT
Mailing Address - State:TX
Mailing Address - Zip Code:79836-4817
Mailing Address - Country:US
Mailing Address - Phone:915-851-0012
Mailing Address - Fax:
Practice Address - Street 1:12391 ORCHARD PARK
Practice Address - Street 2:
Practice Address - City:CLINT
Practice Address - State:TX
Practice Address - Zip Code:79836-4817
Practice Address - Country:US
Practice Address - Phone:915-851-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility