Provider Demographics
NPI:1881472561
Name:GARCIA, CESAR IVAN (DNAP, CRNA)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:IVAN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DNAP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 ALTA VISTA DR APT 3
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4412
Mailing Address - Country:US
Mailing Address - Phone:956-263-7806
Mailing Address - Fax:
Practice Address - Street 1:301 W EXPY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-3098
Practice Address - Country:US
Practice Address - Phone:956-263-7806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136379367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered