Provider Demographics
NPI:1396495610
Name:GARCIA MARTINEZ, CARLOS AGUSTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:AGUSTIN
Last Name:GARCIA MARTINEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5881 ACACIA CIR APT 1717
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4880
Mailing Address - Country:US
Mailing Address - Phone:262-745-7302
Mailing Address - Fax:
Practice Address - Street 1:5881 ACACIA CIR APT 1717
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4880
Practice Address - Country:US
Practice Address - Phone:262-745-7302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist