=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477824621
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | IRIS VANESSA GARCIA D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2012
-----------------------------------------------------
Last Update Date | 01/19/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2201 S I-35 E L-22
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76205-8192
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-484-2525
-----------------------------------------------------
Fax | 512-366-9789
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1907 SAN SABA LN
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006-5733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-845-0716
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 11943
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------