Healthcare Provider Details

I. General information

NPI: 1710811021
Provider Name (Legal Business Name): MR. RICHARDO DEAN GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. RICK DEAN GARCIA

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 COLFAX ST
BLAIR NE
68008-2116
US

IV. Provider business mailing address

1205 COLFAX ST
BLAIR NE
68008-2116
US

V. Phone/Fax

Practice location:
  • Phone: 402-672-1796
  • Fax:
Mailing address:
  • Phone: 402-672-1796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberH12648839
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: