Provider Demographics
NPI:1154133775
Name:CORIA-GARCIA, ROSIO
Entity type:Individual
Prefix:
First Name:ROSIO
Middle Name:
Last Name:CORIA-GARCIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RIO GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7419
Mailing Address - Country:US
Mailing Address - Phone:956-351-9703
Mailing Address - Fax:
Practice Address - Street 1:100 RIO GRANDE DR
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-7419
Practice Address - Country:US
Practice Address - Phone:956-351-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7971103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7971Medicaid