Provider Demographics
NPI:1487683371
Name:EILEEN TALUSAN-GARCIA MD PA
Entity Type:Organization
Organization Name:EILEEN TALUSAN-GARCIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR, MANAGED CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-785-7676
Mailing Address - Street 1:PO BOX 16757
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79490-6757
Mailing Address - Country:US
Mailing Address - Phone:806-785-2045
Mailing Address - Fax:806-785-0872
Practice Address - Street 1:7501 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3367
Practice Address - Country:US
Practice Address - Phone:806-793-7257
Practice Address - Fax:806-799-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5014207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF18487Medicare UPIN
00633XMedicare PIN
8C8269Medicare ID - Type Unspecified