Healthcare Provider Details

I. General information

NPI: 1578252870
Provider Name (Legal Business Name): BRANDON RAY GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 PHILLIPS AVE
HIGH POINT NC
27262-7075
US

IV. Provider business mailing address

905 PHILLIPS AVE
HIGH POINT NC
27262-7075
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2040
  • Fax: 336-802-2041
Mailing address:
  • Phone: 336-802-2040
  • Fax: 336-802-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRTL23-0441
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2026-00114
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: