Provider Demographics
NPI:1699943563
Name:GLADYS GARCIA
Entity type:Organization
Organization Name:GLADYS GARCIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:956-787-7262
Mailing Address - Street 1:2306 S CAGE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6755
Mailing Address - Country:US
Mailing Address - Phone:956-787-7262
Mailing Address - Fax:956-787-7274
Practice Address - Street 1:2306 S CAGE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6755
Practice Address - Country:US
Practice Address - Phone:956-787-7262
Practice Address - Fax:956-787-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0096016332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6082960001Medicare NSC