Provider Demographics
NPI:1124122593
Name:DE LA GARZA, ANDRES NOE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:NOE
Last Name:DE LA GARZA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 WINDWAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-2433
Mailing Address - Country:US
Mailing Address - Phone:210-657-0101
Mailing Address - Fax:210-657-7214
Practice Address - Street 1:8110 WINDWAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-2433
Practice Address - Country:US
Practice Address - Phone:210-657-0101
Practice Address - Fax:210-657-7214
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19755122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist