Provider Demographics
NPI:1881892206
Name:DR GARCIA AND ASSOCIATES, PC
Entity type:Organization
Organization Name:DR GARCIA AND ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JACOBS
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:574-243-2384
Mailing Address - Street 1:6501 GRAPE RD
Mailing Address - Street 2:SUITE 178
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-1007
Mailing Address - Country:US
Mailing Address - Phone:574-243-2384
Mailing Address - Fax:
Practice Address - Street 1:6501 GRAPE RD
Practice Address - Street 2:SUITE 178
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1007
Practice Address - Country:US
Practice Address - Phone:574-243-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN238830Medicare ID - Type Unspecified
INT90471Medicare UPIN