Basic Information
Provider Information
NPI: 1770086472
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA
FirstName: MONICA
MiddleName: MCDANIEL
NamePrefix:  
NameSuffix:  
Credential: LVN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2831 CHALET RIDGE DR
Address2:  
City: KATY
State: TX
PostalCode: 774940642
CountryCode: US
TelephoneNumber: 8327329423
FaxNumber:  
Practice Location
Address1: 12371 S KIRKWOOD RD
Address2:  
City: STAFFORD
State: TX
PostalCode: 774772836
CountryCode: US
TelephoneNumber: 7139959292
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/09/2018
LastUpdateDate: 03/09/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000X132289TXY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


Home