Healthcare Provider Details

I. General information

NPI: 1255977161
Provider Name (Legal Business Name): REGINA GARCIA APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 22ND ST
LUBBOCK TX
79410-1334
US

IV. Provider business mailing address

5103 ITASCA ST
LUBBOCK TX
79416-1228
US

V. Phone/Fax

Practice location:
  • Phone: 806-796-3000
  • Fax: 806-796-3006
Mailing address:
  • Phone: 806-441-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP142610
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: