Provider Demographics
NPI:1013928902
Name:GARCIA, ALEX (OD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AVE RAFAEL CORDERO
Mailing Address - Street 2:POST NET SAM'S CLUB, PMB 153, PO BOX 4960
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3740
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:
Practice Address - Street 1:345 AVE HOSTOS
Practice Address - Street 2:MAYAGUEZ VA OUTPATIENT CLINIC
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1507
Practice Address - Country:US
Practice Address - Phone:787-834-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR576152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist