Provider Demographics
NPI:1427105337
Name:ROBERT R. GARCIA
Entity type:Organization
Organization Name:ROBERT R. GARCIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:361-533-1195
Mailing Address - Street 1:5656 S STAPLES ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4692
Mailing Address - Country:US
Mailing Address - Phone:361-806-2650
Mailing Address - Fax:361-814-1385
Practice Address - Street 1:5656 S STAPLES ST STE 300
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4692
Practice Address - Country:US
Practice Address - Phone:361-806-2650
Practice Address - Fax:361-814-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003584251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000123700Medicaid
TX001015965Medicaid
TX000123700Medicaid