Provider Demographics
NPI:1346418738
Name:GARCIA HEART CENTER PLLC
Entity Type:Organization
Organization Name:GARCIA HEART CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-631-3046
Mailing Address - Street 1:1111 W FRANK AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3308
Mailing Address - Country:US
Mailing Address - Phone:936-631-3046
Mailing Address - Fax:936-631-3050
Practice Address - Street 1:1111 W FRANK AVE STE 202
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3308
Practice Address - Country:US
Practice Address - Phone:936-631-3046
Practice Address - Fax:936-631-3050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5076174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z538Medicare PIN