Provider Demographics
NPI:1154702447
Name:GARZA, MAYRA ELIZABETH (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MAYRA
Middle Name:ELIZABETH
Last Name:GARZA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 E PRICE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3527
Mailing Address - Country:US
Mailing Address - Phone:956-548-7400
Mailing Address - Fax:956-621-3689
Practice Address - Street 1:191 E PRICE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3527
Practice Address - Country:US
Practice Address - Phone:956-548-7400
Practice Address - Fax:956-621-3689
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128290363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354851301Medicaid
TX467256YMJMMedicare PIN