Provider Demographics
NPI:1104162106
Name:HIGUERA-GARCIA, JUAN CARLOS (MSN, RN, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:CARLOS
Last Name:HIGUERA-GARCIA
Suffix:
Gender:M
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 MILL CROSSING PL APT 270
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-3889
Mailing Address - Country:US
Mailing Address - Phone:337-936-2630
Mailing Address - Fax:
Practice Address - Street 1:1007 MILL CROSSING PL APT 270
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-3889
Practice Address - Country:US
Practice Address - Phone:337-936-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758551363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health