Healthcare Provider Details

I. General information

NPI: 1588629372
Provider Name (Legal Business Name): SANDY L GARCIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 15TH ST
AUSTIN TX
78701-1930
US

IV. Provider business mailing address

616 DEEP EDDY AVE
AUSTIN TX
78703-4514
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK5945
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberK5945
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: