Healthcare Provider Details

I. General information

NPI: 1326424029
Provider Name (Legal Business Name): MIGUEL A GARCIA-CARO MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 YORKTOWN DR
ALEXANDRIA LA
71303-3621
US

IV. Provider business mailing address

146 YORKTOWN DR
ALEXANDRIA LA
71303-3621
US

V. Phone/Fax

Practice location:
  • Phone: 318-416-5060
  • Fax:
Mailing address:
  • Phone: 318-416-5060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD.07117R
License Number StateLA

VIII. Authorized Official

Name: DR. MIGUEL A GARCIA-CARO
Title or Position: OWNER
Credential: MD
Phone: 318-416-5060