Provider Demographics
NPI:1215258660
Name:DAVID E. GARZA, D.O, P.A.
Entity type:Organization
Organization Name:DAVID E. GARZA, D.O, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:956-717-2971
Mailing Address - Street 1:6801 MCPHERSON RD
Mailing Address - Street 2:333
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6402
Mailing Address - Country:US
Mailing Address - Phone:956-717-2971
Mailing Address - Fax:956-717-2973
Practice Address - Street 1:6801 MCPHERSON RD
Practice Address - Street 2:333
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6402
Practice Address - Country:US
Practice Address - Phone:956-717-2971
Practice Address - Fax:956-717-2973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX216901301Medicaid
TXTXB102885Medicare PIN
TXE69206Medicare UPIN