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General NPI Number Information
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NPI Number | 1013289768
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Entity Type | Individual
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Provider Name | MARTINA O GARCIA
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Gender | Female
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 801 BASS BLVD
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City | EDINBURG
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State | TX
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Zip | 78542-5183
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Country | US
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Telephone | 956-239-0771
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Fax | 956-316-4049
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Provider Business Mailing Address
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Address Line | PO BOX 2584
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City | EDINBURG
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State | TX
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Zip | 78540-2584
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Country | US
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Telephone | 956-239-0771
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Fax | 956-316-4049
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 15405909
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License Number State | TX
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