Provider Demographics
NPI:1972513976
Name:GARCIA, SAMUEL T JR (M D)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:T
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 PECAN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3695
Mailing Address - Country:US
Mailing Address - Phone:956-686-6050
Mailing Address - Fax:956-686-6359
Practice Address - Street 1:4115 PECAN BLVD STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-3695
Practice Address - Country:US
Practice Address - Phone:956-686-6050
Practice Address - Fax:956-686-6359
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120544501Medicaid
TXE43862Medicare UPIN
TX00F33GMedicare ID - Type Unspecified