Provider Demographics
NPI:1992131486
Name:CORONADO GARCIA, AIDA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AIDA
Middle Name:
Last Name:CORONADO GARCIA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:AIDA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 5358
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5358
Mailing Address - Country:US
Mailing Address - Phone:956-362-5673
Mailing Address - Fax:
Practice Address - Street 1:4770 N EXPRESSWAY STE 305B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3110
Practice Address - Country:US
Practice Address - Phone:956-621-1654
Practice Address - Fax:956-621-1829
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX729584363LF0000X
TXAP124095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350798004Medicaid