Provider Demographics
NPI:1891574315
Name:GARCIA, ADRIANA NICOLE
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:NICOLE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 TANDEM BLVD APT 180
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6614
Mailing Address - Country:US
Mailing Address - Phone:832-597-0824
Mailing Address - Fax:
Practice Address - Street 1:204 W. SOUTH STREET P.O. BOX 218
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78646-0218
Practice Address - Country:US
Practice Address - Phone:512-570-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist