Provider Demographics
NPI:1336279611
Name:GARCIA, ALBERT (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 LAS COLINAS DR APT C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4885
Mailing Address - Country:US
Mailing Address - Phone:512-533-9978
Mailing Address - Fax:512-467-9613
Practice Address - Street 1:5120 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2614
Practice Address - Country:US
Practice Address - Phone:512-420-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT8062255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAT0806OtherSTATE LICENSURE