Healthcare Provider Details

I. General information

NPI: 1912376872
Provider Name (Legal Business Name): JOSE MIGUEL GARCIA LOERA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5344 E US HIGHWAY 83 BUILDING B STE 3
RIO GRANDE CITY TX
78582-9413
US

IV. Provider business mailing address

2431 PACIFIC PALM DR
RIO GRANDE CITY TX
78582-3468
US

V. Phone/Fax

Practice location:
  • Phone: 956-716-6055
  • Fax:
Mailing address:
  • Phone: 956-844-2957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number40402
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: