Provider Demographics
NPI:1366065245
Name:GARCIA, ANGELA SUSAN (RD)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SUSAN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 POINT SPGS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5645
Mailing Address - Country:US
Mailing Address - Phone:210-630-2490
Mailing Address - Fax:
Practice Address - Street 1:615 POINT SPGS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5645
Practice Address - Country:US
Practice Address - Phone:210-630-2490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14157766-4901133V00000X
TXDT81383133V00000X
FLND12772133V00000X
MDDX6715133V00000X
NMNDP-2025-0023133V00000X
NV40823-DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty