Provider Demographics
NPI:1841300118
Name:GARCIA, ARNULFO ALEXANDER (PA C)
Entity type:Individual
Prefix:
First Name:ARNULFO
Middle Name:ALEXANDER
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6245
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-6245
Mailing Address - Country:US
Mailing Address - Phone:405-562-4221
Mailing Address - Fax:405-562-4249
Practice Address - Street 1:2308 W HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-6729
Practice Address - Country:US
Practice Address - Phone:918-968-0079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200055250AMedicaid
OK200055250AMedicaid
249525601Medicare PIN