Provider Demographics
NPI:1003616855
Name:GARCIA, JOSE LUIS JR (MA)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:GARCIA
Suffix:JR
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E FM 1626 APT 10201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2678
Mailing Address - Country:US
Mailing Address - Phone:347-861-5898
Mailing Address - Fax:
Practice Address - Street 1:120 PRECISION # A100A300
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-5925
Practice Address - Country:US
Practice Address - Phone:512-354-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8082103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst