Provider Demographics
NPI:1215714357
Name:GARZA, MARCIE STEPHANIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARCIE
Middle Name:STEPHANIE
Last Name:GARZA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 S SHARY BLVD APT 323
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0317
Mailing Address - Country:US
Mailing Address - Phone:956-358-4924
Mailing Address - Fax:
Practice Address - Street 1:1205 N RAUL LONGORIA RD STE I
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3721
Practice Address - Country:US
Practice Address - Phone:956-782-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist