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General NPI Number Information
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NPI Number | 1396976544
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Entity Type | Organization
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Legal Business Name | EXPRESS OCC MED
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 1900 N EXPRESSWAY # 77B-2
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City | BROWNSVILLE
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State | TX
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Zip | 78521-1556
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Country | US
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Telephone | 956-504-7245
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Fax | 956-548-1199
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Provider Business Mailing Address
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Address Line | 1900 N EXPRESSWAY # 77B-2
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City | BROWNSVILLE
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State | TX
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Zip | 78521-1556
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Country | US
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Telephone | 956-504-7245
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Fax | 956-548-1199
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JUAN MARCOS GARCIA
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Credential | M.D
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Telephone | 956-504-7245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | J9582
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | J9582
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License Number State | TX
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