Provider Demographics
NPI:1104330372
Name:GARCIA, CESAR R (LCDC)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:R
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SAN DIEGO AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1813
Mailing Address - Country:US
Mailing Address - Phone:956-465-9791
Mailing Address - Fax:956-544-4343
Practice Address - Street 1:700 E LEVEE ST STE 101
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-5267
Practice Address - Country:US
Practice Address - Phone:956-548-0028
Practice Address - Fax:956-544-4343
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8803101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)