Provider Demographics
NPI:1316647910
Name:GARCIA, VICTORIA KAITLIN (MA, LAT, ATC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:KAITLIN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W UNIVERSITY AVE
Mailing Address - Street 2:LKD CENTER
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79968-0660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 W UNIVERSITY AVE
Practice Address - Street 2:LKD CENTER
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79968-8900
Practice Address - Country:US
Practice Address - Phone:915-747-6800
Practice Address - Fax:915-747-6022
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT80282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer