Healthcare Provider Details

I. General information

NPI: 1750375150
Provider Name (Legal Business Name): ELENA GARCIA MD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 MEDICAL CENTER BLVD STE 100
CONROE TX
77304-2809
US

IV. Provider business mailing address

503 MEDICAL CENTER BLVD STE. 100
CONROE TX
77304-2809
US

V. Phone/Fax

Practice location:
  • Phone: 936-788-1060
  • Fax: 936-788-2844
Mailing address:
  • Phone: 936-788-1060
  • Fax: 936-788-2844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL1050
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: