Healthcare Provider Details

I. General information

NPI: 1871709436
Provider Name (Legal Business Name): JAVIER GARCIA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 W OAKLAWN RD
PLEASANTON TX
78064-4033
US

IV. Provider business mailing address

310 W OAKLAWN RD
PLEASANTON TX
78064-4033
US

V. Phone/Fax

Practice location:
  • Phone: 830-569-5818
  • Fax: 830-569-5220
Mailing address:
  • Phone: 830-569-8940
  • Fax: 830-569-8320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16188
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: