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General NPI Number Information
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NPI Number | 1376191130
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Entity Type | Individual
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Provider Name | JACQUELINE SARA GARCIA M.S., SLP - INTERN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 15820 ADDISON RD
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City | ADDISON
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State | TX
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Zip | 75001-3549
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Country | US
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Telephone | 866-919-3240
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Fax |
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Provider Business Mailing Address
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Address Line | 11900 HOBBY HORSE CT APT 321
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City | AUSTIN
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State | TX
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Zip | 78758-2925
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Country | US
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Telephone | 512-897-2281
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 116115
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License Number State | TX
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