Provider Demographics
NPI:1578386561
Name:GOVEA GARCIA, CARLA DINORA
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:DINORA
Last Name:GOVEA GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:DINORA
Other - Last Name:GOVEA VAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 TERRACE CIR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-5826
Mailing Address - Country:US
Mailing Address - Phone:956-312-5041
Mailing Address - Fax:
Practice Address - Street 1:605 TERRACE CIR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5826
Practice Address - Country:US
Practice Address - Phone:956-312-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179420363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily