Healthcare Provider Details

I. General information

NPI: 1730564857
Provider Name (Legal Business Name): HOMERO GARCIA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 E PRICE RD BLDG F
BROWNSVILLE TX
78521-3531
US

IV. Provider business mailing address

2534 BOCA CHICA BLVD
BROWNSVILLE TX
78521-2310
US

V. Phone/Fax

Practice location:
  • Phone: 956-504-6080
  • Fax: 956-504-6419
Mailing address:
  • Phone: 956-546-2000
  • Fax: 718-640-2713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: