Provider Demographics
NPI:1023213220
Name:GARCIA FAMILY MEDICINE & WOMEN'S HEALTH, LLC
Entity Type:Organization
Organization Name:GARCIA FAMILY MEDICINE & WOMEN'S HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-867-2065
Mailing Address - Street 1:201 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-9703
Mailing Address - Country:US
Mailing Address - Phone:816-867-2065
Mailing Address - Fax:888-807-2718
Practice Address - Street 1:201 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-9703
Practice Address - Country:US
Practice Address - Phone:816-867-2065
Practice Address - Fax:888-807-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1275549974OtherGARCIA NPI
MO205021918Medicaid
MO2000160495OtherLICENSE #
MO1023213220OtherGFMWH NPI
MOX910000 GFM PINMedicare PIN
MOH26189Medicare UPIN