Provider Demographics
NPI:1689332371
Name:GARCIA, PATRICIA REIDER
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:REIDER
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:BROOKE ARMY MEDICAL CENTER (MCHE-ZMD-Z)
Mailing Address - Street 2:3551 ROGER BROOKE DRIVE
Mailing Address - City:JBSA FT. SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-1680
Mailing Address - Fax:210-916-7482
Practice Address - Street 1:BROOKE ARMY MEDICAL CENTER (MCHE-ZMD-Z)
Practice Address - Street 2:3551 ROGER BROOKE DRIVE
Practice Address - City:JBSA FT. SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:74823-4504
Practice Address - Country:US
Practice Address - Phone:210-916-1680
Practice Address - Fax:210-916-7483
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX453067163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1386291736OtherMILITARY TREATMENT FACILITY