Provider Demographics
NPI:1740567585
Name:GARCIA, BROOKE (PA)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:HOESTEREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2535 S DOWNING ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5848
Mailing Address - Country:US
Mailing Address - Phone:720-524-1367
Mailing Address - Fax:720-524-1422
Practice Address - Street 1:2535 S DOWNING ST STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5848
Practice Address - Country:US
Practice Address - Phone:720-524-1367
Practice Address - Fax:720-524-1422
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2026363A00000X
CA22912363A00000X
COPA.0005749363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200402930AMedicaid
OKP01057281OtherRR MEDICARE
OKP01057281OtherRR MEDICARE
OKOKAAA2917Medicare PIN