MEDICARE: ISKRA IRINA GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1154804	TX

General Provider Information

NPI Number	:	1851151732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISKRA IRINA GARCIA

Provider Business Mailing Address
First Line	:	5603 ENGLAND DR
Second Line	:
City	:	SANTA TERESA
State	:	NM
Zip	:	88008-9679
Country	:	US
Telephone Number	:	915-309-6232
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 N ZARAGOZA RD UNIT A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7905
Country	:	US
Telephone Number	:	915-500-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	03/23/2024

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