Provider Demographics
NPI:1427650399
Name:GARCIA, MAXINE GAY (APRN)
Entity type:Individual
Prefix:
First Name:MAXINE
Middle Name:GAY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 KYSER WAY
Mailing Address - Street 2:STE 205
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-2783
Mailing Address - Country:US
Mailing Address - Phone:972-643-8727
Mailing Address - Fax:972-643-8728
Practice Address - Street 1:9191 KYSER WAY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1902
Practice Address - Country:US
Practice Address - Phone:972-643-8727
Practice Address - Fax:972-643-8728
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019605207R00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty