Provider Demographics
NPI:1104592591
Name:DE LA GARZA, JHARUMI (DMD)
Entity type:Individual
Prefix:DR
First Name:JHARUMI
Middle Name:
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 BACH ST
Mailing Address - Street 2:
Mailing Address - City:IOWA COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1340
Mailing Address - Country:US
Mailing Address - Phone:713-517-7263
Mailing Address - Fax:
Practice Address - Street 1:7101 W GRAND PKWY S STE 160
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8656
Practice Address - Country:US
Practice Address - Phone:832-222-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX377681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice