Healthcare Provider Details

I. General information

NPI: 1134093271
Provider Name (Legal Business Name): JESUS GARCIA DNP, APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 I-10 W
FORT STOCKTON TX
79735
US

IV. Provider business mailing address

PO BOX 501
ODESSA TX
79760-0501
US

V. Phone/Fax

Practice location:
  • Phone: 432-336-2004
  • Fax: 432-336-4540
Mailing address:
  • Phone: 432-703-7339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1215625
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: