Provider Demographics
NPI:1932567351
Name:GARCIA, AMADOR JR
Entity Type:Individual
Prefix:
First Name:AMADOR
Middle Name:
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 E MAHALA AVE
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573-5916
Mailing Address - Country:US
Mailing Address - Phone:956-222-9858
Mailing Address - Fax:
Practice Address - Street 1:3504 E MAHALA AVE
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573-5916
Practice Address - Country:US
Practice Address - Phone:956-222-9858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications