Provider Demographics
NPI:1972286953
Name:GARCIA, DIANA A (LMT, GTS)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMT, GTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GALENA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77547-2613
Mailing Address - Country:US
Mailing Address - Phone:832-649-1963
Mailing Address - Fax:
Practice Address - Street 1:11811 EAST FWY STE 452
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1950
Practice Address - Country:US
Practice Address - Phone:832-649-1963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT135202225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist