Healthcare Provider Details

I. General information

NPI: 1669436200
Provider Name (Legal Business Name): EVELIO D GARCIA MD FACC FSCAI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/02/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MAIN AVE
HAYTI SD
57241-0301
US

IV. Provider business mailing address

PO BOX 301
HAYTI SD
57241-0301
US

V. Phone/Fax

Practice location:
  • Phone: 605-783-2999
  • Fax: 605-783-1399
Mailing address:
  • Phone: 605-783-2999
  • Fax: 605-783-1399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number7092
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberJ6112
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number7092
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: