Healthcare Provider Details

I. General information

NPI: 1164482394
Provider Name (Legal Business Name): DOROTHEA M. GARCIA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 FLOWER ST
BAKERSFIELD CA
93305-4144
US

IV. Provider business mailing address

45 NE LOOP 410 STE 900
SAN ANTONIO TX
78216-5831
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-6000
  • Fax:
Mailing address:
  • Phone: 210-375-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number739329
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: