Provider Demographics
NPI:1174289920
Name:GARCIA, NIDIA YADIRA
Entity type:Individual
Prefix:MRS
First Name:NIDIA
Middle Name:YADIRA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NIDIA
Other - Middle Name:Y
Other - Last Name:TERRAZAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10878 FM 2589
Mailing Address - Street 2:
Mailing Address - City:DUMAS
Mailing Address - State:TX
Mailing Address - Zip Code:79029-6812
Mailing Address - Country:US
Mailing Address - Phone:806-717-8820
Mailing Address - Fax:
Practice Address - Street 1:600 W 3RD ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4008
Practice Address - Country:US
Practice Address - Phone:806-717-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX386582355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant