Provider Demographics
NPI:1477660884
Name:GARCIA, GONZALO H JR (MD)
Entity Type:Individual
Prefix:MR
First Name:GONZALO
Middle Name:H
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6750 N MACARTHUR BLVD
Mailing Address - Street 2:#206
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039
Mailing Address - Country:US
Mailing Address - Phone:972-406-9911
Mailing Address - Fax:972-406-9930
Practice Address - Street 1:6750 N MACARTHUR BLVD
Practice Address - Street 2:#206
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039
Practice Address - Country:US
Practice Address - Phone:972-406-9911
Practice Address - Fax:972-406-9930
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ4139207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A7290OtherBLUE CROSS BLUE SHIELD
TX142085301Medicaid
8A7290OtherBC/BS
TXG99520Medicare UPIN
TX142085301Medicaid