Provider Demographics
NPI:1770531287
Name:GARCIA, JUANITA V (NURSE PRACTITIONER C)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:V
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E RIDGE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1251
Mailing Address - Country:US
Mailing Address - Phone:956-632-6032
Mailing Address - Fax:956-971-9539
Practice Address - Street 1:222 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1251
Practice Address - Country:US
Practice Address - Phone:956-632-6036
Practice Address - Fax:956-971-9539
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234002363LA2200X, 363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165029301Medicaid