1417144569 NPI number — JONAS GARCIA MD AND ASSOCIATES

Table of content: (NPI 1417144569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417144569 NPI number — JONAS GARCIA MD AND ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JONAS GARCIA MD AND ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417144569
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 BINZ ST
Provider Second Line Business Mailing Address:
1260
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77004-6937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-522-9934
Provider Business Mailing Address Fax Number:
713-522-1838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 BINZ ST
Provider Second Line Business Practice Location Address:
1260
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77004-6937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-522-9934
Provider Business Practice Location Address Fax Number:
713-522-1838
Provider Enumeration Date:
10/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
JONAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
713-522-9934

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  F1566 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 31835 . This is a "AMERICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81060Y . This is a "BC/BS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4456498 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 9853306 . This is a "UNIVERSAL HEALTHCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 060003592 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 113989101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10020318 . This is a "AMERICAID" identifier . This identifiers is of the category "OTHER".




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