Provider Demographics
NPI:1104695782
Name:GARCIA, LEDA GUADALUPE (DNP-PNP)
Entity type:Individual
Prefix:
First Name:LEDA
Middle Name:GUADALUPE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DNP-PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 RUSTIC SPGS
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3020
Mailing Address - Country:US
Mailing Address - Phone:210-478-2619
Mailing Address - Fax:
Practice Address - Street 1:3315 BURKE RD STE 101
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1873
Practice Address - Country:US
Practice Address - Phone:713-472-8680
Practice Address - Fax:713-472-0744
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1107082363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics