Provider Demographics
NPI:1740687433
Name:GARCIA, DOROTEO (PTA)
Entity type:Individual
Prefix:
First Name:DOROTEO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 HIGHWAY 6 STE 260
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5146
Mailing Address - Country:US
Mailing Address - Phone:281-240-3140
Mailing Address - Fax:281-605-5075
Practice Address - Street 1:1449 HIGHWAY 6 STE 260
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5146
Practice Address - Country:US
Practice Address - Phone:281-240-3140
Practice Address - Fax:281-605-5075
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2107878225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant