Provider Demographics
NPI:1790532521
Name:YOUR DOCTOR ON DEMAND PLLC
Entity type:Organization
Organization Name:YOUR DOCTOR ON DEMAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICKOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-859-9593
Mailing Address - Street 1:18772 FORTY SIX PKWY BLDG 6
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6899
Mailing Address - Country:US
Mailing Address - Phone:210-859-9593
Mailing Address - Fax:210-659-2025
Practice Address - Street 1:18772 FORTY SIX PKWY BLDG 6
Practice Address - Street 2:SUITE 602
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6899
Practice Address - Country:US
Practice Address - Phone:210-859-9593
Practice Address - Fax:210-659-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty