Provider Demographics
NPI:1770849432
Name:MICHELLE GARCIA PSYD & ASSOCIATES
Entity Type:Organization
Organization Name:MICHELLE GARCIA PSYD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:713-397-3104
Mailing Address - Street 1:PO BOX 8915
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8915
Mailing Address - Country:US
Mailing Address - Phone:713-397-3104
Mailing Address - Fax:832-415-2627
Practice Address - Street 1:29818 SUNWILLOW CREEK DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2848
Practice Address - Country:US
Practice Address - Phone:713-397-3104
Practice Address - Fax:832-415-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366599862Medicaid