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General NPI Number Information
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NPI Number | 1720408669
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Entity Type | Individual
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Provider Name | JONATHAN GARCIA SLP-ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 35 BUSINESS DR STE D
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City | BROWNSVILLE
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State | TX
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Zip | 78521-4587
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Country | US
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Telephone | 956-541-6976
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Fax | 866-945-9435
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Provider Business Mailing Address
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Address Line | 35 BUSINESS DRIVE STE. D
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-541-6976
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Fax | 866-945-9435
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 36680
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License Number State | TX
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