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Individual
TERRY BOURGAULT GARCIA
Active
Individual
TERRY BOURGAULT GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP113872
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072781
CCNA
—
05
—
171941101
—
TX
05
—
171941102
—
TX
01
—
8007UG
BLUE CROSS/BLUE SHIELD
TX
01
—
87171U
BCBS
TX
01
—
P00474623
RAILROAD MEDICARE
TX
Enumeration date
09/28/2006
Last updated
08/01/2019
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