Provider Demographics
NPI:1558137448
Name:GARCIA, MARIYA
Entity Type:Individual
Prefix:
First Name:MARIYA
Middle Name:
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 1:24970 FM 88
Mailing Address - Street 2:
Mailing Address - City:MONTE ALTO
Mailing Address - State:TX
Mailing Address - Zip Code:78538-3322
Mailing Address - Country:US
Mailing Address - Phone:956-373-4700
Mailing Address - Fax:
Practice Address - Street 1:700 N SAINT MARYS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-3507
Practice Address - Country:US
Practice Address - Phone:210-866-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB1031482106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician