Provider Demographics
NPI:1396919627
Name:EVELIO D GARCIA MD, FACC
Entity type:Organization
Organization Name:EVELIO D GARCIA MD, FACC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:DC
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:972-494-4600
Mailing Address - Street 1:2046 FOREST LN STE 100
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7939
Mailing Address - Country:US
Mailing Address - Phone:972-494-4600
Mailing Address - Fax:
Practice Address - Street 1:2046 FOREST LN STE 100
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7939
Practice Address - Country:US
Practice Address - Phone:972-494-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6112207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133683609Medicaid
TX0084BLOtherBLUE SHIELD BLUE CROSS
TX8F0489Medicare PIN
TX0084BLOtherBLUE SHIELD BLUE CROSS