Provider Demographics
NPI:1952472664
Name:GARCIA, MARY DOLORES (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:DOLORES
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6000 OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-2862
Mailing Address - Country:US
Mailing Address - Phone:361-510-4730
Mailing Address - Fax:361-462-4098
Practice Address - Street 1:6000 OCEAN DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-2862
Practice Address - Country:US
Practice Address - Phone:361-510-4730
Practice Address - Fax:361-462-4098
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX223565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ34727Medicare UPIN