Provider Demographics
NPI:1720319643
Name:ALLEN R. GARCIA M.D.P.A.
Entity Type:Organization
Organization Name:ALLEN R. GARCIA M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-223-3119
Mailing Address - Street 1:730 N MAIN AVE
Mailing Address - Street 2:STE 815
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1152
Mailing Address - Country:US
Mailing Address - Phone:210-223-3119
Mailing Address - Fax:210-223-1148
Practice Address - Street 1:730 N MAIN AVE
Practice Address - Street 2:STE 815
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1152
Practice Address - Country:US
Practice Address - Phone:210-223-3119
Practice Address - Fax:210-223-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2105174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032923701Medicaid
TXOA5711Medicare PIN