Provider Demographics
NPI:1013078534
Name:GARCIA, RUDY T (DDS)
Entity Type:Individual
Prefix:MR
First Name:RUDY
Middle Name:T
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 1:515 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520
Mailing Address - Country:US
Mailing Address - Phone:281-427-5170
Mailing Address - Fax:281-422-1551
Practice Address - Street 1:515 PARK ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520
Practice Address - Country:US
Practice Address - Phone:281-427-5170
Practice Address - Fax:281-422-1551
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice