Provider Demographics
NPI:1366008625
Name:GARCIA GALDO, MANUEL ANGEL (MD)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:ANGEL
Last Name:GARCIA GALDO
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 1:1133 JOHN FREEMAN BLVD STE JJLS80
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2809
Mailing Address - Country:US
Mailing Address - Phone:713-500-6714
Mailing Address - Fax:239-343-5348
Practice Address - Street 1:925 N SHEPHERD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-6526
Practice Address - Country:US
Practice Address - Phone:713-486-8550
Practice Address - Fax:713-486-7201
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME152896208M00000X
TXU5962208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114977500Medicaid