Provider Demographics
NPI:1134357080
Name:GARCIA, RONALD DAVID
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DAVID
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 S SHEPHERD DR STE 240
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1517
Mailing Address - Country:US
Mailing Address - Phone:713-529-0120
Mailing Address - Fax:713-529-6958
Practice Address - Street 1:2621 S SHEPHERD DR STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1517
Practice Address - Country:US
Practice Address - Phone:713-529-0120
Practice Address - Fax:713-529-6958
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist