Provider Demographics
NPI:1912242314
Name:GARCIA, JUAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 SE MILITARY DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-2800
Mailing Address - Country:US
Mailing Address - Phone:210-924-4884
Mailing Address - Fax:210-921-0398
Practice Address - Street 1:1313 SE MILITARY DR
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-2800
Practice Address - Country:US
Practice Address - Phone:210-924-4884
Practice Address - Fax:210-921-0398
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor