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NPI Code Detail

MEDICARE: MR. JOHN GARCIA JR. PA-C

MEDICARE: MR. JOHN GARCIA JR. PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA 01536TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA01536OTHERTXLICENSE #

General Provider Information

NPI Number : 1235161225
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN GARCIA JR. PA-C
Provider Business Mailing Address
First Line : 2601 W LAKE HOUSTON PKWY
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-5222
Country : US
Telephone Number : 281-360-7502
Fax Number : 281-360-0587
Provider Business Practice Location Address
First Line : 2601 W LAKE HOUSTON PKWY
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-5222
Country : US
Telephone Number : 281-360-7502
Fax Number : 281-360-0587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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