Provider Demographics
NPI:1508147752
Name:GARCIA, LETICIA LEAL
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:LEAL
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 1:2102 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3573
Mailing Address - Country:US
Mailing Address - Phone:956-202-2308
Mailing Address - Fax:
Practice Address - Street 1:510 VICTORIA LN STE 1
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3231
Practice Address - Country:US
Practice Address - Phone:956-202-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525952163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX525952OtherNURSE PRACTITIONER-FAMILY NURSE PRACTITIONER