Provider Demographics
NPI:1083777338
Name:GARCIA, GILBERTO JAIME (LPC)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:JAIME
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 SURETY DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2061
Mailing Address - Country:US
Mailing Address - Phone:915-781-1337
Mailing Address - Fax:915-881-4959
Practice Address - Street 1:6090 SURETY DR
Practice Address - Street 2:STE. 200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2061
Practice Address - Country:US
Practice Address - Phone:915-781-1337
Practice Address - Fax:915-881-4959
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174201701Medicaid
TX174201701Medicaid