Organization
NORTHSIDE OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GONZALO HUMBERTO GARCIA MD (OWNER)
(972) 406-9911
Entity
Organization
Contact information
Practice address
6750 N MACARTHUR BLVD, STE 206, IRVING, TX 75039-2875
(972) 406-9911
Mailing address
6750 N MACARTHUR BLVD, STE 206, IRVING, TX 75039-2875
(972) 406-9911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093EZ
BLUE CROSS BLUE SHIELD
TX
05
—
142412901
—
TN
Enumeration date
09/06/2007
Last updated
06/10/2009
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