Active NPI
Mildred Marie Garcia, COTA
- Occupational Therapy Assistant
- Victoria, TX
National Provider Identifier
1235468372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 207209
- Practice address
- 4206 Retama Cir
Victoria, TX 77901-2765 - Phone
- (361) 582-0611
- Fax
- (361) 582-4978
- NPI assigned
- Dec 21, 2009
- Last updated
- Dec 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 207209 | TX | Primary |
Addresses
Primary practice location
4206 Retama Cir
Victoria, TX 77901-2765
Mailing address
PO Box 5171
Victoria, TX 77903-5171
Phone (361) 582-0602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164704201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207209 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261353600000",
"number": "1235468372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5171",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779035171",
"telephone_number": "361-582-0602",
"fax_number": "361-582-4978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4206 RETAMA CIR",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779012765",
"telephone_number": "361-582-0611",
"fax_number": "361-582-4978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "MILDRED",
"middle_name": "MARIE",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-21",
"last_updated": "2009-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "207209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164704201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.