Provider Demographics
NPI:1821213174
Name:GARCIA, LOUIS GLENN (DDS)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:GLENN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 CALLAGHAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4720
Mailing Address - Country:US
Mailing Address - Phone:210-377-3344
Mailing Address - Fax:210-377-3593
Practice Address - Street 1:8131 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4720
Practice Address - Country:US
Practice Address - Phone:210-377-3344
Practice Address - Fax:210-377-3593
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14503122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist