Provider Demographics
NPI:1104143379
Name:GEORGE H. GARCIA, D.D.S., PLLC
Entity type:Organization
Organization Name:GEORGE H. GARCIA, D.D.S., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-791-2266
Mailing Address - Street 1:6801 MCPHERSON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6403
Mailing Address - Country:US
Mailing Address - Phone:956-791-2266
Mailing Address - Fax:956-791-2268
Practice Address - Street 1:6801 MCPHERSON RD STE 104
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6403
Practice Address - Country:US
Practice Address - Phone:956-791-2266
Practice Address - Fax:956-791-2268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196849701Medicaid