Active NPI
Jose N Garcia-Davalos, M.D.
- Ophthalmology Physician
- Laredo, TX
National Provider Identifier
1295742146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- F3131
- Practice address
- 6416 Polaris Dr Ste 1B
Laredo, TX 78041-2089 - Phone
- (956) 791-7100
- Fax
- (956) 791-0144
- NPI assigned
- Aug 2, 2006
- Last updated
- Dec 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | F3131 | TX | Primary |
Addresses
Primary practice location
6416 Polaris Dr Ste 1B
Laredo, TX 78041-2089
Mailing address
6416 Polaris Dr Ste 1B
Laredo, TX 78041-2089
Phone (956) 791-7100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G65E | Other | TX | BLUE CROSS BLUE SHIELD |
| 742595954 | Other | TX | TAX ID |
| 130372907 | Medicaid | TX |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090917000604 | TX | Practitioner - Ophthalmology | 5496755175 | Practice locations: Laredo, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Other, 1967
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6416 Polaris Dr
Suite 1B
Laredo, TX 78041-2089
Phone (956) 791-7100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 27 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734048000000",
"number": "1295742146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6416 POLARIS DR STE 1B",
"city": "LAREDO",
"state": "TX",
"postal_code": "780412089",
"telephone_number": "956-791-7100",
"fax_number": "956-791-0144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6416 POLARIS DR STE 1B",
"city": "LAREDO",
"state": "TX",
"postal_code": "780412089",
"telephone_number": "956-791-7100",
"fax_number": "956-791-0144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA-DAVALOS",
"first_name": "JOSE",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "F3131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00G65E",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "742595954",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130372907",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.