Organization
IVAN H GARCIA MD PC
Active
Parent organization
IVAN H GARCIA MD PC
Other names
Omni Eye Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
IVAN H GARCIA MD PC
Authorized official
MR. EDWARD JOHN WASLOSKI O.D. (FOUNDING MEMBER)
(410) 277-3937
Entity
Organization
Contact information
Practice address
2925 LORD BALTIMORE DR, SUITE 300, BALTIMORE, MD 21244-2634
(410) 277-3937
(410) 281-9388
Mailing address
2925 LORD BALTIMORE DR, SUITE 300, BALTIMORE, MD 21244-2634
(410) 277-3937
(410) 281-9388
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412506100
—
MD
01
—
TA0943
LICENSE
MD
01
—
TA1633
LICENSE
MD
01
—
TA1850
LICENSE
MD
01
—
TA2095
LICENSE
MD
Enumeration date
03/05/2009
Last updated
03/05/2009
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