Healthcare Provider Details

I. General information

NPI: 1508859455
Provider Name (Legal Business Name): MIGUEL ANGEL GARCIA-CARO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 10/10/2015
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: 318-416-5064
Mailing address:
  • Phone: 318-416-5060
  • Fax: 318-416-5064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number07117R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: