Provider Demographics
NPI:1316020258
Name:GARCIA, ROMEO MARIO JR (OTR)
Entity Type:Individual
Prefix:
First Name:ROMEO
Middle Name:MARIO
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 HWY 83
Mailing Address - Street 2:PO BOX 14892
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-4892
Mailing Address - Country:US
Mailing Address - Phone:956-765-1277
Mailing Address - Fax:956-765-5339
Practice Address - Street 1:2113 N US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3588
Practice Address - Country:US
Practice Address - Phone:956-765-1277
Practice Address - Fax:956-765-5339
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105936225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T2687OtherBCBS PROVIDER NUMBER
TX126132301Medicaid
TX00453WOtherMERCY HEALTH PLANS PIN
TX8T2687OtherBCBS PROVIDER NUMBER