Individual provider Active NPI

Raul Garcia, PA-C

  • Medical Physician Assistant
  • Mission, TX
National Provider Identifier
1104411966
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14377 Issued in TX
Practice address
1512 E Griffin Pkwy Ste 2
Mission, TX 78572-2422
Phone
(956) 519-7088
NPI assigned
Mar 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA14377 TX
Medical Physician Assistant 363AM0700X PA14377 TX Primary

Addresses

Primary practice location

1512 E Griffin Pkwy Ste 2
Mission, TX 78572-2422

Mailing address

PO Box 721
Penitas, TX 78576-0721
Phone (956) 537-8654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250314003142 TX Practitioner - Physician Assistant 5799207148 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mario R Anzaldua MD PA Family Medicine CurrentSince Mar 7, 2021 Accepting new patients
Wellmed Medical Group, PA Family Medicine PastSince Mar 7, 2021 Accepting new patients

Locations

1512 E Griffin Pkwy
Ste 2
Mission, TX 78572
Phone (956) 519-7088

Interoperability endpoints

  • Direct secure messaging: raulgarcia@jtjs.ssdirect.aprima.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1104411966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721",
            "city": "PENITAS",
            "state": "TX",
            "postal_code": "785760721",
            "telephone_number": "956-537-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 E GRIFFIN PKWY STE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785722422",
            "telephone_number": "956-519-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "RAUL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "PA14377",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA14377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.