Provider Demographics
NPI:1891904090
Name:GARCIA, VIVIAN I (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:I
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8721 BELIZE DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8000
Mailing Address - Country:US
Mailing Address - Phone:956-725-7238
Mailing Address - Fax:956-326-2449
Practice Address - Street 1:2500 ZACATECAS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-6814
Practice Address - Country:US
Practice Address - Phone:956-718-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX567726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX567726OtherRN - FNP-RX AUTH