MEDICARE: ANA GARCIA MED, LPC-INTERN, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	83001	TX

General Provider Information

NPI Number	:	1184244311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA GARCIA MED, LPC-INTERN, NCC

Provider Business Mailing Address
First Line	:	4515 FOUNTAINHEAD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77066-2632
Country	:	US
Telephone Number	:	713-966-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	13810 CHAMPION FOREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-1844
Country	:	US
Telephone Number	:	713-231-6801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	04/17/2020

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