Provider Demographics
NPI:1598879348
Name:GARCIA, ENRIQUE T (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:T
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 E. SAUNDERS
Mailing Address - Street 2:B-250
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5443
Mailing Address - Country:US
Mailing Address - Phone:956-794-8871
Mailing Address - Fax:956-794-8874
Practice Address - Street 1:1710 E SAUNDERS ST
Practice Address - Street 2:B-250
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5443
Practice Address - Country:US
Practice Address - Phone:956-794-8871
Practice Address - Fax:956-794-8874
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2393174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133153008Medicaid
TXF27289Medicare UPIN
TX133153008Medicaid