Basic Information
Provider Information
NPI: 1003003419
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA
FirstName: NADINE
MiddleName: LOUISE
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6522 CAMP BULLIS #5203
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782561660
CountryCode: US
TelephoneNumber: 2103944868
FaxNumber:  
Practice Location
Address1: 6522 CAMP BULLIS RD APT 5203
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782562374
CountryCode: US
TelephoneNumber: 2103944868
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/29/2007
LastUpdateDate: 11/23/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X20501TXY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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