Provider Demographics
NPI:1235750332
Name:GARCIA, CHRISTOPHER CLEMENTE
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CLEMENTE
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8353
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-8353
Mailing Address - Country:US
Mailing Address - Phone:956-373-7910
Mailing Address - Fax:
Practice Address - Street 1:1310 N TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-4210
Practice Address - Country:US
Practice Address - Phone:956-968-8689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist