Provider Demographics
NPI:1720567696
Name:PUENTE-GARCIA, CHRISTINA (LVN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PUENTE-GARCIA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 BARLOW TRL
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-1873
Mailing Address - Country:US
Mailing Address - Phone:361-774-1864
Mailing Address - Fax:
Practice Address - Street 1:1813 BARLOW TRL
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-1873
Practice Address - Country:US
Practice Address - Phone:361-774-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170052164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty