Provider Demographics
NPI:1851848907
Name:GARCIA, ILSE MARIA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ILSE
Middle Name:MARIA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 NACOGDOCHES RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3332
Mailing Address - Country:US
Mailing Address - Phone:210-496-5588
Mailing Address - Fax:
Practice Address - Street 1:3100 NACOGDOCHES RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3332
Practice Address - Country:US
Practice Address - Phone:210-496-5588
Practice Address - Fax:210-451-8058
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2247225100000X
TX1261885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist