Provider Demographics
NPI:1841025400
Name:GARCIA, CLARISSA LIZETTE (MSN, RN)
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:LIZETTE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:CLARISSA
Other - Middle Name:LIZETTE
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:5514 BUCKSKIN DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6177
Mailing Address - Country:US
Mailing Address - Phone:956-231-8072
Mailing Address - Fax:
Practice Address - Street 1:1700 E SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5474
Practice Address - Country:US
Practice Address - Phone:956-796-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1022402163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse