Individual provider Active NPI

Matthew Frederick Garcia

  • General Practice Physician
  • Fort Hood, TX
National Provider Identifier
1770104028
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
T3280 Issued in TX
Practice address
36065 Santa Fe Ave
Fort Hood, TX 76544-5060
Phone
(254) 288-8000
NPI assigned
Apr 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X T3280 TX Primary

Addresses

Primary practice location

36065 Santa Fe Ave
Fort Hood, TX 76544-5060

Mailing address

119 Summertime Dr
San Antonio, TX 78216-3553
Phone (210) 724-9561

Other practice location 1

300 East Hospital Road
Fort Gordon, GA 30905-5650
Phone (210) 724-9561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T3280TXMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1770104028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SUMMERTIME DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782163553",
            "telephone_number": "210-724-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36065 SANTA FE AVE",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "254-288-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 East Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Fort Gordon",
            "state": "GA",
            "postal_code": "309055650",
            "country_code": "US",
            "telephone_number": "210-724-9561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MATTHEW",
        "middle_name": "FREDERICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T3280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.