Provider Demographics
NPI:1407655103
Name:GARZA, LAURA LISA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LISA
Last Name:GARZA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17697 ABD RD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-1753
Mailing Address - Country:US
Mailing Address - Phone:956-428-2100
Mailing Address - Fax:956-428-2170
Practice Address - Street 1:17697 ABD RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-1753
Practice Address - Country:US
Practice Address - Phone:956-428-2100
Practice Address - Fax:956-428-2170
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9973101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)