Provider Demographics
NPI:1629240478
Name:GARCIA, ERNEST G (MS, AUDIOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MS, AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8918 N DREY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4577
Mailing Address - Country:US
Mailing Address - Phone:602-861-1921
Mailing Address - Fax:602-861-1921
Practice Address - Street 1:8918 N DREY LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4577
Practice Address - Country:US
Practice Address - Phone:602-568-9173
Practice Address - Fax:602-861-1921
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA142237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0408580OtherBCBS
AZP00747026OtherRAILROAD MEDICARE
AZZ121857Medicare PIN