MEDICARE: KENNETH GARCIA

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	101Y00000X	Counselor	83724	TX

General Provider Information

NPI Number	:	1669187175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH GARCIA

Provider Business Mailing Address
First Line	:	5915 VIKING DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-4137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 VIKING DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-4137
Country	:	US
Telephone Number	:	210-380-7739
Fax Number	:

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

Provider Enumeration Date	:	01/18/2023
Last Update Date	:	01/18/2023

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Directions to “ KENNETH GARCIA ” Practice Location

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