Provider Demographics
NPI:1790086981
Name:GARCIA, ELIDA
Entity Type:Individual
Prefix:
First Name:ELIDA
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 1:1145 ROSS ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4421
Mailing Address - Country:US
Mailing Address - Phone:956-361-6000
Mailing Address - Fax:956-361-6060
Practice Address - Street 1:1145 ROSS ST
Practice Address - Street 2:SUITE E
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4421
Practice Address - Country:US
Practice Address - Phone:956-361-6000
Practice Address - Fax:956-361-6060
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX358042355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX35804OtherSTATE LICENSE