MEDICARE: JOSE DOMINGO GARCIA FNP

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	363L00000X	Nurse Practitioner	667462	TX

General Provider Information

NPI Number	:	1972673770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE DOMINGO GARCIA FNP

Provider Business Mailing Address
First Line	:	156 MAIN ST
Second Line	:	SUITE 100
City	:	BUDA
State	:	TX
Zip	:	78610
Country	:	US
Telephone Number	:	512-351-4405
Fax Number	:	612-659-7101

Provider Business Practice Location Address
First Line	:	135 BUNTON CREEK RD STE 100
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-5701
Country	:	US
Telephone Number	:	512-268-2068
Fax Number	:

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	11/04/2025

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