Provider Demographics
NPI:1598948994
Name:CARMELO A. GARCIA, MD FAAFP PA
Entity Type:Organization
Organization Name:CARMELO A. GARCIA, MD FAAFP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMELO
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-842-4334
Mailing Address - Street 1:5304 DUNSTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8886
Mailing Address - Country:US
Mailing Address - Phone:214-842-4334
Mailing Address - Fax:
Practice Address - Street 1:5304 DUNSTER DRIVE
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8886
Practice Address - Country:US
Practice Address - Phone:972-523-4315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1989600-01Medicaid
00219RMedicare PIN
TX1989600-01Medicaid
TX00219RMedicare PIN