MEDICARE: TORIBIO R GARCIA MD MBA RPH

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	208000000X	Pediatrics Physician	G8122	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84A919	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1649364829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TORIBIO R GARCIA MD MBA RPH

Provider Business Mailing Address
First Line	:	3302 SOUTH ALAMEDA ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-1821
Country	:	US
Telephone Number	:	361-851-0333
Fax Number	:	361-851-5160

Provider Business Practice Location Address
First Line	:	3302 SOUTH ALAMEDA ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-1821
Country	:	US
Telephone Number	:	361-851-0333
Fax Number	:	361-851-5160

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	MR. TORIBIO R GARCIA
Credential	:	MD MBA RPH
Telephone Number	:	361-851-0333

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/22/2020

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