Provider Demographics
NPI:1962478933
Name:GARCIA, JAN JR (MD)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 TEXAS AVE
Mailing Address - Street 2:STE 2200
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-338-2766
Mailing Address - Fax:281-338-1476
Practice Address - Street 1:333 TEXAS AVE
Practice Address - Street 2:STE 2200
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-338-2766
Practice Address - Fax:281-338-1476
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8118208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0033BYMedicare ID - Type Unspecified
C15927Medicare UPIN