MEDICARE: GEORGE GARCIA D.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
1	111N00000X	Chiropractor	12040	TX
2	111NS0005X	Sports Physician Chiropractor	12040	TX

General Provider Information

NPI Number	:	1518233303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE GARCIA D.C.

Provider Business Mailing Address
First Line	:	400 N SAINT PAUL ST
Second Line	:	200
City	:	DALLAS
State	:	TX
Zip	:	75201-3114
Country	:	US
Telephone Number	:	214-954-4357
Fax Number	:	469-920-9574

Provider Business Practice Location Address
First Line	:	400 N SAINT PAUL ST
Second Line	:	200
City	:	DALLAS
State	:	TX
Zip	:	75201-3114
Country	:	US
Telephone Number	:	214-954-4357
Fax Number	:	469-920-9574

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

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	04/06/2017

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