MEDICARE: GARCIA'S FAMILY WELLNESS CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831732981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARCIA'S FAMILY WELLNESS CLINIC LLC

Provider Business Mailing Address
First Line	:	7506 DANIEL KRUG
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-4405
Country	:	US
Telephone Number	:	361-947-7621
Fax Number	:	210-587-2416

Provider Business Practice Location Address
First Line	:	7506 DANIEL KRUG
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-4405
Country	:	US
Telephone Number	:	361-947-7621
Fax Number	:	210-587-2416

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ARTEMIO GARCIA JR.
Credential	:	PHD
Telephone Number	:	361-947-7621

Provider Enumeration Date	:	10/22/2019
Last Update Date	:	10/22/2019

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