Provider Demographics
NPI:1710610134
Name:CARLOS GARCIA-MAYORCA LLC
Entity Type:Organization
Organization Name:CARLOS GARCIA-MAYORCA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:NICOLAS
Authorized Official - Last Name:GARCIA-MAYORCA
Authorized Official - Suffix:SR
Authorized Official - Credentials:LSA
Authorized Official - Phone:281-250-0074
Mailing Address - Street 1:12014 RAMLA PLACE TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2636
Mailing Address - Country:US
Mailing Address - Phone:281-250-0074
Mailing Address - Fax:
Practice Address - Street 1:12014 RAMLA PLACE TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-2636
Practice Address - Country:US
Practice Address - Phone:281-250-0074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-04
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty