Individual provider Active NPI

Louis Alfonso Garcia, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Laredo, TX
National Provider Identifier
1689725384
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
21879 Issued in TX
Practice address
2600 Cedar Ave
Dental Clinic
Laredo, TX 78040-4040
Phone
(956) 523-7500
Fax
(956) 718-4021
NPI assigned
Jan 16, 2007
Last updated
Apr 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21879 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21879 TX Primary

Addresses

Primary practice location

2600 Cedar Ave
Dental Clinic
Laredo, TX 78040-4040

Mailing address

PO Box 40397
Uthscsa
San Antonio, TX 78229-1397
Phone (956) 523-7459

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515002049 TX Practitioner - Oral Surgery 6406032424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21879TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1689725384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40397",
            "address_2": "UTHSCSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782291397",
            "telephone_number": "956-523-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CEDAR AVE",
            "address_2": "DENTAL CLINIC",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780404040",
            "telephone_number": "956-523-7500",
            "fax_number": "956-718-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "LOUIS",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21879",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "21879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.