Provider Demographics
NPI:1366767998
Name:ERNESTO GARZA MD PA
Entity type:Organization
Organization Name:ERNESTO GARZA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-569-7090
Mailing Address - Street 1:PO BOX 7820
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0820
Mailing Address - Country:US
Mailing Address - Phone:210-569-7090
Mailing Address - Fax:210-569-7089
Practice Address - Street 1:414 NAVARRO ST
Practice Address - Street 2:STE 1034
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2516
Practice Address - Country:US
Practice Address - Phone:210-569-7090
Practice Address - Fax:210-569-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214948601Medicaid
TX214948601Medicaid