Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99068 | TX |
NPI | 1073757688 |
---|---|
Provider Name | Ms. Monica Nicole Garza-Vickery |
First Address | San Antonio, TX 78247-1944 |
Second Address | San Antonio, TX 78233-4628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2009 |
Last Update Date | 27/04/2009 |