Provider Demographics
NPI:1518095066
Name:GARCIA, TORIBIO R (MD, MBA, RPH)
Entity Type:Individual
Prefix:
First Name:TORIBIO
Middle Name:R
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD, MBA, RPH
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:13501 CARLOS FIFTH CT
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6913
Mailing Address - Country:US
Mailing Address - Phone:361-949-9379
Mailing Address - Fax:361-851-5160
Practice Address - Street 1:4707 EVERHART RD
Practice Address - Street 2:STE 104B
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2792
Practice Address - Country:US
Practice Address - Phone:361-851-0333
Practice Address - Fax:361-851-5160
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG81222080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133212404Medicaid
TX133212404Medicaid
TXC15901Medicare UPIN