Provider Demographics
NPI:1518908300
Name:GP PODIATRY ASSOCIATES
Entity Type:Organization
Organization Name:GP PODIATRY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:W
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-492-1970
Mailing Address - Street 1:800 W. AIRPORT FREEWAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6207
Mailing Address - Country:US
Mailing Address - Phone:214-492-1970
Mailing Address - Fax:
Practice Address - Street 1:800 W. AIRPORT FREEWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6207
Practice Address - Country:US
Practice Address - Phone:214-492-1970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1583213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190959001Medicaid
5416760001OtherMEDICARE RAILROAD PTAN
TX0009NPOtherBCBS GROUP ID
TX190959001Medicaid
TX00W878Medicare PIN