=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508387549
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARTON CHASE GARCIA DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2017
-----------------------------------------------------
Last Update Date | 10/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9191 PINECROFT DR STE 100
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-2797
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-909-7722
-----------------------------------------------------
Fax | 281-909-7723
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9191 PINECROFT DR STE 100
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-2797
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-909-7722
-----------------------------------------------------
Fax | 281-909-7723
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213EP1101X
-----------------------------------------------------
Taxonomy Name | Primary Podiatric Medicine Podiatrist
-----------------------------------------------------
License Number | 3037
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | T50-2017
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------