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General NPI Number Information
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NPI Number | 1619450038
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Entity Type | Individual
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Provider Name | MARIA CORAZON BATUCAN GARCIA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 03/17/2019
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Provider Practice Location Address
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Address Line | 3710 4TH ST
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City | LUBBOCK
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State | TX
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Zip | 79415-5346
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Country | US
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Telephone | 806-763-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 PONTIAC AVE
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City | LUBBOCK
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State | TX
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Zip | 79407-1823
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Country | US
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Telephone | 806-283-8283
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2102470
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1315933
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License Number State | TX
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