Provider Demographics
NPI:1942481163
Name:IBRAHIM GARCIA-MOWATT M.D., P.A.
Entity Type:Organization
Organization Name:IBRAHIM GARCIA-MOWATT M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-MOWATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:713-863-0492
Mailing Address - Street 1:PO BOX 22659
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77227-2659
Mailing Address - Country:US
Mailing Address - Phone:713-863-0492
Mailing Address - Fax:
Practice Address - Street 1:427 W 20TH ST STE 704
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2433
Practice Address - Country:US
Practice Address - Phone:713-863-0492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2599207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB22870Medicare UPIN
TX00964TMedicare PIN