MEDICARE: DR. SAMUEL GARCIA SR. LPC-S

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	101YM0800X	Mental Health Counselor	66628	TX
2	101YP2500X	Professional Counselor	66628	TX
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	66628	TX

General Provider Information

NPI Number	:	1891056305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL GARCIA SR. LPC-S

Provider Business Mailing Address
First Line	:	9 KINGS TOWER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1717
Country	:	US
Telephone Number	:	210-849-7197
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 KINGS TOWER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1717
Country	:	US
Telephone Number	:	210-849-7197
Fax Number	:

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

Provider Enumeration Date	:	05/31/2012
Last Update Date	:	11/16/2023

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