Provider Demographics
NPI:1124121637
Name:GARCIA, RONALD K (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:K
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5282 MEDICAL DR STE 540
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6071
Mailing Address - Country:US
Mailing Address - Phone:210-614-7865
Mailing Address - Fax:210-614-4762
Practice Address - Street 1:5282 MEDICAL DR STE 540
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6071
Practice Address - Country:US
Practice Address - Phone:210-614-7865
Practice Address - Fax:210-614-4762
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0073JAOtherBCBS
TXE04517Medicare UPIN
8989B6Medicare PIN