Healthcare Provider Details

I. General information

NPI: 1912115577
Provider Name (Legal Business Name): SONIA GARCIA-DURAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5407 WALZEM RD
SAN ANTONIO TX
78218-2126
US

IV. Provider business mailing address

PO BOX 120427
SAN ANTONIO TX
78212-9627
US

V. Phone/Fax

Practice location:
  • Phone: 210-646-8833
  • Fax: 210-646-9606
Mailing address:
  • Phone: 210-223-3543
  • Fax: 210-227-0282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number594711
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: