Provider Demographics
NPI:1497095780
Name:GARCIA, TIFFANY LEIGH
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LEIGH
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 1:1050 E FLAMINGO RD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7429
Mailing Address - Country:US
Mailing Address - Phone:702-733-8098
Mailing Address - Fax:702-215-7309
Practice Address - Street 1:1050 E FLAMINGO RD STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7429
Practice Address - Country:US
Practice Address - Phone:702-733-8098
Practice Address - Fax:702-215-7309
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker