Provider Demographics
NPI:1629062039
Name:GARCIA, GILBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:281-548-7334
Mailing Address - Fax:281-548-7363
Practice Address - Street 1:104 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-548-7334
Practice Address - Fax:281-548-7363
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1197208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092312001Medicaid
TX760597463OtherCOMMERICAL
TX092312002Medicaid