Provider Demographics
NPI:1861919144
Name:GARCIA, MARY LENORE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LENORE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50689
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76206
Mailing Address - Country:US
Mailing Address - Phone:940-323-9404
Mailing Address - Fax:940-323-9422
Practice Address - Street 1:2435 W. OAK ST.
Practice Address - Street 2:SUITE 103
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-323-9404
Practice Address - Fax:940-323-9422
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily