Provider Demographics
NPI:1922027838
Name:GARCIA, JOSE R (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6801 MCPHERSON RD
Mailing Address - Street 2:SUITE 327
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6402
Mailing Address - Country:US
Mailing Address - Phone:956-727-4337
Mailing Address - Fax:956-718-9759
Practice Address - Street 1:6801 MCPHERSON RD
Practice Address - Street 2:SUITE 327
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6402
Practice Address - Country:US
Practice Address - Phone:956-727-4337
Practice Address - Fax:956-718-9759
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9875207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0038DROtherBLUECROSS
TX092329401Medicaid
TX092329401Medicaid
00102JMedicare ID - Type Unspecified