Provider Demographics
NPI:1831427905
Name:GARCIA, ROEL (OTR)
Entity type:Individual
Prefix:
First Name:ROEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 KNIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6851
Mailing Address - Country:US
Mailing Address - Phone:956-292-9308
Mailing Address - Fax:
Practice Address - Street 1:2215 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8472
Practice Address - Country:US
Practice Address - Phone:956-668-1203
Practice Address - Fax:956-668-1462
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113333225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist