Provider Demographics
NPI:1710021407
Name:GARVIN, LUCIA (RN)
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:
Last Name:GARVIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:JOURDANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78026-2003
Mailing Address - Country:US
Mailing Address - Phone:830-769-2371
Mailing Address - Fax:
Practice Address - Street 1:1203 BROADWAY
Practice Address - Street 2:
Practice Address - City:JOURDANTON
Practice Address - State:TX
Practice Address - Zip Code:78026-2003
Practice Address - Country:US
Practice Address - Phone:830-769-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX252306163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse