Healthcare Provider Details

I. General information

NPI: 1972798031
Provider Name (Legal Business Name): ENRIQUE GARCIA PENA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ENRIQUE GARCIA PENA M.D.

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 06/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22001 SOUTHWEST FWY STE 300
RICHMOND TX
77469-7001
US

IV. Provider business mailing address

4911 SANDHILL DR
SUGAR LAND TX
77479-5320
US

V. Phone/Fax

Practice location:
  • Phone: 281-633-4940
  • Fax: 281-633-4943
Mailing address:
  • Phone: 281-238-7870
  • Fax: 281-633-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberP4168
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: