Healthcare Provider Details

I. General information

NPI: 1932309838
Provider Name (Legal Business Name): JAVIER GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 HOSPITAL DR
SOUTH WILLIAMSON KY
41503-4095
US

IV. Provider business mailing address

1110 N BUCKNER BLVD STE 103
DALLAS TX
75218-3498
US

V. Phone/Fax

Practice location:
  • Phone: 606-237-1790
  • Fax:
Mailing address:
  • Phone: 606-487-7503
  • Fax: 606-439-6987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number41009
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: