Provider Demographics
NPI:1619109717
Name:GARCIA, STEVEN L (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 ATASCOCITA RD STE 600
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4455
Mailing Address - Country:US
Mailing Address - Phone:281-913-7764
Mailing Address - Fax:281-913-7765
Practice Address - Street 1:3809 ATASCOCITA RD STE 600
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4455
Practice Address - Country:US
Practice Address - Phone:281-913-7764
Practice Address - Fax:281-913-7765
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004539-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01866233Medicaid