Healthcare Provider Details

I. General information

NPI: 1700715067
Provider Name (Legal Business Name): BREANNA MARIE GARCIA BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4002 24TH ST
LUBBOCK TX
79410-1894
US

IV. Provider business mailing address

13804 VERNON AVE
LUBBOCK TX
79423-4565
US

V. Phone/Fax

Practice location:
  • Phone: 806-725-6717
  • Fax:
Mailing address:
  • Phone: 806-543-2941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1036506
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: