Provider Demographics
NPI:1154757334
Name:NELLY I. GARCIA DO PA
Entity type:Organization
Organization Name:NELLY I. GARCIA DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-793-0026
Mailing Address - Street 1:4000 SURFSIDE BLVD
Mailing Address - Street 2:APT 203
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78402-1400
Mailing Address - Country:US
Mailing Address - Phone:361-793-0026
Mailing Address - Fax:713-850-1327
Practice Address - Street 1:2606 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1833
Practice Address - Country:US
Practice Address - Phone:361-902-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8653207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty