Provider Demographics
NPI:1720795735
Name:GARCIA ALVA, JENNYFER PATRICIA (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:JENNYFER
Middle Name:PATRICIA
Last Name:GARCIA ALVA
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 CARRIAGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3673
Mailing Address - Country:US
Mailing Address - Phone:830-370-4498
Mailing Address - Fax:
Practice Address - Street 1:1641 CARRIAGE CREEK DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-3673
Practice Address - Country:US
Practice Address - Phone:830-370-4498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097064363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology