Healthcare Provider Details

I. General information

NPI: 1891128617
Provider Name (Legal Business Name): SAMANTHA GARCIA ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FANNIN ST FONDREN 270
HOUSTON TX
77030-2703
US

IV. Provider business mailing address

6565 FANNIN ST FONDREN 270
HOUSTON TX
77030-2703
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-3020
  • Fax: 713-790-4207
Mailing address:
  • Phone: 713-441-3020
  • Fax: 713-790-4207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP121418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: