Healthcare Provider Details
I. General information
NPI: 1518983170
Provider Name (Legal Business Name): GARCIA & ASSOCIATES, CLEAR LAKE.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 PROFESSIONAL PARK DR
WEBSTER TX
77598-4123
US
IV. Provider business mailing address
15 PROFESSIONAL PARK DR
WEBSTER TX
77598-4123
US
V. Phone/Fax
- Phone: 281-332-1559
- Fax: 281-332-3394
- Phone: 281-332-1559
- Fax: 281-332-3394
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JENNIFER
L
LEAL
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 713-453-3521