Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M0409 | TX |
N | 2080P0202X | Pediatric Cardiologist | E-5052 | AR |
Y | 2080P0203X | Pediatric Critical Care Doctor | E-5052 | AR |
NPI | 1194805440 |
---|---|
Provider Name | Mrs. Xiomara Carmen Garcia Casal |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06120015200 | QUALCHOICE (01) | |
5N719 | BCBS (01) | |
I52229 | (02) |