Provider Demographics
NPI:1588774525
Name:GARCIA, CARLOS O (DMD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:O
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 E 8TH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7288
Mailing Address - Country:US
Mailing Address - Phone:956-968-1090
Mailing Address - Fax:956-447-9449
Practice Address - Street 1:1116 E 8TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7288
Practice Address - Country:US
Practice Address - Phone:956-968-1090
Practice Address - Fax:956-447-9449
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187351223G0001X
PR7931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice