Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 21472 | OK |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 21472 | OK |
N | 207NP0225X | Pediatric Dermatologist | 21472 | OK |
N | 207NS0135X | Procedural Dermatology | 21472 | OK |
NPI | 1013985217 |
---|---|
Provider Name | Dr. Carlos Andres Garcia |
First Address | Oklahoma City, OK 73109-3835 |
Second Address | Oklahoma City, OK 73109-3835 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 10/04/2018 |