MEDICARE: MR. JOE MICHAEL GARCIA JR.

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	103K00000X	Behavior Analyst	1-17-26523	TX

General Provider Information

NPI Number	:	1710405857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOE MICHAEL GARCIA JR.

Provider Business Mailing Address
First Line	:	925 S MASON RD STE 514
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-3874
Country	:	US
Telephone Number	:	210-324-9197
Fax Number	:	281-391-6415

Provider Business Practice Location Address
First Line	:	925 S MASON RD STE 514
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-3874
Country	:	US
Telephone Number	:	210-324-9197
Fax Number	:

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

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	06/25/2024

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