Provider Demographics
NPI:1386520716
Name:GARCIA, IVAN (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12884 ROCK CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-5909
Mailing Address - Country:US
Mailing Address - Phone:915-309-8996
Mailing Address - Fax:
Practice Address - Street 1:1390 NORTHWESTERN DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-8003
Practice Address - Country:US
Practice Address - Phone:915-503-1959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1194104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health