Healthcare Provider Details

I. General information

NPI: 1972513976
Provider Name (Legal Business Name): SAMUEL T. GARCIA JR. M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 PECAN BLVD STE B
MCALLEN TX
78501-3695
US

IV. Provider business mailing address

4115 PECAN BLVD STE B
MCALLEN TX
78501-3695
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-6050
  • Fax: 956-686-6359
Mailing address:
  • Phone: 956-686-6050
  • Fax: 956-686-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH6821
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: