Healthcare Provider Details

I. General information

NPI: 1093821506
Provider Name (Legal Business Name): JOSE GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8302 MINNESOTA LN
AUSTIN TX
78745-6360
US

IV. Provider business mailing address

8302 MINNESOTA LN
AUSTIN TX
78745-6360
US

V. Phone/Fax

Practice location:
  • Phone: 512-891-0056
  • Fax: 512-891-0075
Mailing address:
  • Phone: 512-891-0056
  • Fax: 512-891-0075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberE6359
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE6359
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: