Healthcare Provider Details

I. General information

NPI: 1487736583
Provider Name (Legal Business Name): RODOLFO LUIS GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 S MCCOLL RD
EDINBURG TX
78539-5503
US

IV. Provider business mailing address

4504 S PROFESSIONAL DR APT 12307
EDINBURG TX
78539-0073
US

V. Phone/Fax

Practice location:
  • Phone: 956-661-7100
  • Fax: 956-362-7510
Mailing address:
  • Phone: 956-362-7553
  • Fax: 956-362-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberL9204
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: