Provider Demographics
NPI:1285390971
Name:GARCIA-MARTINEZ, ALEXANDER RICHARD (LCDC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:RICHARD
Last Name:GARCIA-MARTINEZ
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7603 BRESNAHAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3631
Mailing Address - Country:US
Mailing Address - Phone:210-269-9820
Mailing Address - Fax:
Practice Address - Street 1:5121 CRESTWAY RD STE 200B
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1975
Practice Address - Country:US
Practice Address - Phone:210-310-3731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12545101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12545OtherTEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES