Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 71400 | WI |
N | 208000000X | Pediatrician | M1694 | TX |
NPI | 1003996356 |
---|---|
Provider Name | Anthony J Garcia-Prats |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53705-3644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
175599302 | (05) | TX |
I38121 | (02) |