Provider Demographics
NPI:1356550032
Name:MICHAEL D GARCIA, MD,P.A.
Entity type:Organization
Organization Name:MICHAEL D GARCIA, MD,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-225-5930
Mailing Address - Street 1:1200 BROOKLYN AVE
Mailing Address - Street 2:SUITE 365
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4803
Mailing Address - Country:US
Mailing Address - Phone:210-225-5930
Mailing Address - Fax:210-476-0246
Practice Address - Street 1:1200 BROOKLYN AVE
Practice Address - Street 2:SUITE 365
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4803
Practice Address - Country:US
Practice Address - Phone:210-225-5930
Practice Address - Fax:210-476-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0009LTOtherBLUE CROSS BLUE SHIELD
TX164169801Medicaid
TX00915WMedicare ID - Type Unspecified