Basic Information
| Provider Information | |||||||||
| NPI: | 1548226418 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LUIS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 MCMILLAN RD | ||||||||
| Address2: | |||||||||
| City: | WEST MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712915327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183294744 | ||||||||
| FaxNumber: | 3183294719 | ||||||||
| Practice Location | |||||||||
| Address1: | 503 MCMILLAN RD | ||||||||
| Address2: | |||||||||
| City: | WEST MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712915327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183294744 | ||||||||
| FaxNumber: | 3183294719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 07/31/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MD.024194 | LA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | MD.024194 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 142815001 | 05 | AR | MEDICAID |