Provider Demographics
NPI:1194390278
Name:GARCIAS FAMILY WELLNESS MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:GARCIAS FAMILY WELLNESS MEDICAL GROUP PLLC
Other - Org Name:GARCIAS FAMILY WELLNESS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALBINO
Authorized Official - Middle Name:J
Authorized Official - Last Name:BENAVIDEZ-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:210-707-7707
Mailing Address - Street 1:3519 PAESANOS PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1266
Mailing Address - Country:US
Mailing Address - Phone:210-481-4265
Mailing Address - Fax:210-851-8374
Practice Address - Street 1:3519 PAESANOS PKWY STE 104
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1266
Practice Address - Country:US
Practice Address - Phone:210-481-4265
Practice Address - Fax:210-851-8374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2084P0800XOtherPSYCHIATRY