Provider Demographics
NPI:1821156597
Name:GARCIA, DIANE MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 DUNBAR DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3041
Mailing Address - Country:US
Mailing Address - Phone:361-578-3257
Mailing Address - Fax:
Practice Address - Street 1:103 DUNBAR DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3041
Practice Address - Country:US
Practice Address - Phone:361-578-3257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100541225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist