Provider Demographics
NPI:1316427826
Name:GARZA, JOSE LUIS JR (SLP/A, MS ED)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:GARZA
Suffix:JR
Gender:M
Credentials:SLP/A, MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 FLORAVISTA DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-2624
Mailing Address - Country:US
Mailing Address - Phone:956-342-9138
Mailing Address - Fax:
Practice Address - Street 1:347 FLORAVISTA DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-2624
Practice Address - Country:US
Practice Address - Phone:956-342-9138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist