Provider Demographics
NPI:1376844795
Name:STEPHANIE H GARCIA MDPA
Entity Type:Organization
Organization Name:STEPHANIE H GARCIA MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-428-7500
Mailing Address - Street 1:5505 S EXPRESSWAY 77
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3214
Mailing Address - Country:US
Mailing Address - Phone:956-428-7500
Mailing Address - Fax:956-428-7501
Practice Address - Street 1:5505 S EXPRESSWAY 77
Practice Address - Street 2:SUITE 304
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3214
Practice Address - Country:US
Practice Address - Phone:956-428-7500
Practice Address - Fax:956-428-7501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4140207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120218OtherMEDICARE PTAN