Provider Demographics
NPI:1437487337
Name:GARCIA, ELEAZAR (PTA)
Entity Type:Individual
Prefix:
First Name:ELEAZAR
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E VETERANS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-5019
Mailing Address - Country:US
Mailing Address - Phone:956-960-5818
Mailing Address - Fax:
Practice Address - Street 1:713 N BENTSEN PALM DR STE H
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78574-3797
Practice Address - Country:US
Practice Address - Phone:956-424-1089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20116562251P0200X, 225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2011656OtherPHYSICAL THERAPIST PROVIDER