MEDICARE: JACQUELINE GARCIA

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	235Z00000X	Speech-Language Pathologist	43876	TX

General Provider Information

NPI Number	:	1699512921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE GARCIA

Provider Business Mailing Address
First Line	:	633 E FERNHURST DR STE 604
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1589
Country	:	US
Telephone Number	:	832-980-7061
Fax Number	:	832-617-0867

Provider Business Practice Location Address
First Line	:	633 E FERNHURST DR STE 604
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1589
Country	:	US
Telephone Number	:	832-980-7061
Fax Number	:	832-617-0867

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

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	07/12/2024

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Directions to “ JACQUELINE GARCIA ” Practice Location

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