Healthcare Provider Details

I. General information

NPI: 1134571144
Provider Name (Legal Business Name): MR. JESUS ALFREDO GARCIA FRANCISCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2016
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WHITE AVE
NASHVILLE TN
37204-2235
US

IV. Provider business mailing address

306 HOBSON AVE
SHELBYVILLE TN
37160-4148
US

V. Phone/Fax

Practice location:
  • Phone: 931-639-0995
  • Fax:
Mailing address:
  • Phone: 931-639-0995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: