Provider Demographics
NPI:1043586159
Name:COSTA GARCIA, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:COSTA GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 HEWITT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-4024
Mailing Address - Country:US
Mailing Address - Phone:305-322-0626
Mailing Address - Fax:877-559-7682
Practice Address - Street 1:2200 NORTH LOOP W STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-1754
Practice Address - Country:US
Practice Address - Phone:713-244-4134
Practice Address - Fax:833-449-5320
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0862207RI0011X, 2086S0129X
TXS0869207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery