Provider Demographics
NPI:1801990932
Name:GARCIA, JOSE L (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 N FOWLER ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-2312
Mailing Address - Country:US
Mailing Address - Phone:575-392-2040
Mailing Address - Fax:575-392-6752
Practice Address - Street 1:2410 N FOWLER ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-2312
Practice Address - Country:US
Practice Address - Phone:575-392-2040
Practice Address - Fax:575-392-6752
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0658207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM55482279Medicaid
NM55482279Medicaid
NM55482279Medicaid
I51413Medicare UPIN