Individual provider Active NPI

Carlos Garcia Fajardo, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1568859742
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q6014 Issued in TX
Practice address
3520 S New Braunfels Ave
Ste. 106a
San Antonio, TX 78223-1404
Phone
(210) 921-3800
Fax
(210) 334-2851
NPI assigned
Apr 24, 2015
Last updated
Jun 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q6014 TX Primary

Addresses

Primary practice location

3520 S New Braunfels Ave
Ste. 106a
San Antonio, TX 78223-1404

Mailing address

720 Pleasanton Rd
San Antonio, TX 78214-1306
Phone (210) 921-3800

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103001130 TX Practitioner - Family Practice 7810207883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
GMG Health Systems Associates PAGroup PAC ID 8123932647, 115 clinicians

Practice addresses (Care Compare)

1130 Goliad Rd
Gonzaba Medical Group
San Antonio, TX 78223-1846
Phone (210) 921-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
GMG Health Systems Associates PA Family Medicine CurrentSince Oct 1, 2015 Accepting new patients

Locations

1130 Goliad Rd
San Antonio, TX 78223

3520 S New Braunfels Ave
Ste 106A
San Antonio, TX 78223

720 Pleasanton Rd
San Antonio, TX 78214

7219 Culebra Rd
San Antonio, TX 78251
Phone (210) 509-2603

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1568859742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 PLEASANTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141306",
            "telephone_number": "210-921-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 S NEW BRAUNFELS AVE",
            "address_2": "STE. 106A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782231404",
            "telephone_number": "210-921-3800",
            "fax_number": "210-334-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA FAJARDO",
        "first_name": "CARLOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q6014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.