Provider Demographics
NPI:1750643300
Name:GARCIA, DAISY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6289
Mailing Address - Country:US
Mailing Address - Phone:956-212-3399
Mailing Address - Fax:
Practice Address - Street 1:1201 BRYCE DR
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4311
Practice Address - Country:US
Practice Address - Phone:956-323-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106698235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1750643300Medicaid