Provider Demographics
NPI:1568916377
Name:GARCIA, LEONARDO JOSE
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:JOSE
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E SAVANNAH AVE BLDG C201
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1110
Mailing Address - Country:US
Mailing Address - Phone:956-792-9928
Mailing Address - Fax:
Practice Address - Street 1:110 E SAVANNAH AVE BLDG C201
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1110
Practice Address - Country:US
Practice Address - Phone:956-792-9928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic