Individual provider Active NPI

Jennyfer Patricia Garcia Alva, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1720795735
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1097064 Issued in TX
Practice address
1641 Carriage Creek Dr
Desoto, TX 75115-3673
Phone
(830) 370-4498
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1097064 TX Primary

Addresses

Primary practice location

1641 Carriage Creek Dr
Desoto, TX 75115-3673

Mailing address

1641 Carriage Creek Dr
Desoto, TX 75115-3673
Phone (830) 370-4498

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

LicenseStateTypeSpecialty
1097064TXMDGerontology Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1720795735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 CARRIAGE CREEK DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153673",
            "telephone_number": "830-370-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 CARRIAGE CREEK DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153673",
            "telephone_number": "830-370-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA ALVA",
        "first_name": "JENNYFER",
        "middle_name": "PATRICIA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1097064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.