Provider Demographics
NPI:1861718678
Name:MARIA DE LA LUZ GARCIA
Entity type:Organization
Organization Name:MARIA DE LA LUZ GARCIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DE LA LUZ
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-787-7313
Mailing Address - Street 1:4623 S ALAMO RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-6529
Mailing Address - Country:US
Mailing Address - Phone:956-787-7313
Mailing Address - Fax:956-787-6849
Practice Address - Street 1:4623 S ALAMO RD
Practice Address - Street 2:SUITE 110
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-6529
Practice Address - Country:US
Practice Address - Phone:956-787-7313
Practice Address - Fax:956-787-6849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129138261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care