Provider Demographics
NPI:1184810418
Name:GARCIA, BALDEMAR (OTR)
Entity type:Individual
Prefix:
First Name:BALDEMAR
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 E NOLANA LOOP
Mailing Address - Street 2:SUITE H
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5838
Mailing Address - Country:US
Mailing Address - Phone:956-566-0722
Mailing Address - Fax:956-720-0882
Practice Address - Street 1:912 E NOLANA LOOP
Practice Address - Street 2:SUITE H
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5838
Practice Address - Country:US
Practice Address - Phone:956-566-0722
Practice Address - Fax:956-720-0882
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111857225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist