Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 211673 | TX |
NPI | 1013459809 |
---|---|
Provider Name | Isabel Garcia |
First Address | Lubbock, TX 79416-1771 |
Second Address | Lubbock, TX 79416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2016 |
Last Update Date | 09/11/2016 |