MEDICARE: GARRETT ANTHONY GARCIA DC

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
1	111N00000X	Chiropractor	14365	TX

General Provider Information

NPI Number	:	1275165805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRETT ANTHONY GARCIA DC

Provider Business Mailing Address
First Line	:	2596 E BARNETT RD STE B
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-4340
Country	:	US
Telephone Number	:	541-622-8376
Fax Number	:	512-814-1074

Provider Business Practice Location Address
First Line	:	1103 CYPRESS CREEK RD STE 102
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-3925
Country	:	US
Telephone Number	:	512-814-1018
Fax Number	:	512-814-1074

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2020
Last Update Date	:	08/29/2023

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