Basic Information
Provider Information
NPI: 1346488822
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA
FirstName: ROLANDO
MiddleName:  
NamePrefix:  
NameSuffix: JR.
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5887
Address2:  
City: ALEXANDRIA
State: LA
PostalCode: 713075887
CountryCode: US
TelephoneNumber: 3184425399
FaxNumber: 3184421586
Practice Location
Address1: 1444 PETERMAN DR
Address2:  
City: ALEXANDRIA
State: LA
PostalCode: 713013432
CountryCode: US
TelephoneNumber: 3184425399
FaxNumber: 3184421586
Other Information
ProviderEnumerationDate: 01/22/2009
LastUpdateDate: 01/22/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XAPO5648LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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