Organization
IRIS WELL CHILD PHYSICALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS GARCIA R.N., PNP (OWNER)
(956) 262-9805
Entity
Organization
Contact information
Practice address
200 W. EDINBURG HWY 107, SUITE B, ELSA, TX 78543-1274
(956) 262-9805
(956) 262-9233
Mailing address
PO BOX 1274, ELSA, TX 78543-1274
(956) 262-9805
(956) 262-9233
Taxonomy
Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
533197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121084101
—
TX
01
—
121084102
MEDICAID-EPSDT
TX
01
—
121392
SUPERIOR HEALTHPLAN NETWORK
TX
01
—
8N8564
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
02/20/2009
Last updated
02/20/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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