Provider Demographics
NPI:1932736097
Name:GARCIA, ISIDRO (LPC)
Entity Type:Individual
Prefix:
First Name:ISIDRO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 CHAMPIONS LANDING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2679
Mailing Address - Country:US
Mailing Address - Phone:304-224-3191
Mailing Address - Fax:
Practice Address - Street 1:4722 CHAMPIONS LANDING DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2679
Practice Address - Country:US
Practice Address - Phone:304-224-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77552101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional