Provider Demographics
NPI:1417545021
Name:GARZA, ROBERT J (PRSS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:GARZA
Suffix:
Gender:M
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 NW 122ND ST APT 1128
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9239
Mailing Address - Country:US
Mailing Address - Phone:405-996-8179
Mailing Address - Fax:
Practice Address - Street 1:4001 NW 122ND ST APT 1128
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9239
Practice Address - Country:US
Practice Address - Phone:405-996-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist