Provider Demographics
NPI:1528343472
Name:GARCIA, LUIS EDMUNDO (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:EDMUNDO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 N 10TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3151
Mailing Address - Country:US
Mailing Address - Phone:956-686-2229
Mailing Address - Fax:956-686-2280
Practice Address - Street 1:6900 N 10TH ST STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3151
Practice Address - Country:US
Practice Address - Phone:956-686-2229
Practice Address - Fax:956-686-2280
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0978208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics