Provider Demographics
NPI:1649344029
Name:GARCIA, AMPARO LOURDES (CPNP)
Entity type:Individual
Prefix:
First Name:AMPARO
Middle Name:LOURDES
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8626 EL PUEBLO PEAK
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-3618
Mailing Address - Country:US
Mailing Address - Phone:210-373-0911
Mailing Address - Fax:
Practice Address - Street 1:203 E EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4316
Practice Address - Country:US
Practice Address - Phone:210-225-7171
Practice Address - Fax:210-225-5819
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX707936363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX741694904Medicare UPIN