Provider Demographics
NPI:1689750200
Name:GARCIA-MOWATT, IBRAHIM (MD)
Entity Type:Individual
Prefix:MR
First Name:IBRAHIM
Middle Name:
Last Name:GARCIA-MOWATT
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 1:427 W 20TH ST
Mailing Address - Street 2:SUITE 704
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-863-0492
Mailing Address - Fax:713-863-9637
Practice Address - Street 1:427 W 20TH ST
Practice Address - Street 2:SUITE 704
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:713-863-0492
Practice Address - Fax:713-863-9637
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2599207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
B22870Medicare UPIN
8224B9Medicare ID - Type Unspecified