Provider Demographics
NPI:1417584582
Name:MADIA, NANCY DE LA GARZA (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:DE LA GARZA
Last Name:MADIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:DE LA GARZA DE LA O
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1604 HOSPITAL PKWY STE 407
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6932
Mailing Address - Country:US
Mailing Address - Phone:972-573-3855
Mailing Address - Fax:833-973-4597
Practice Address - Street 1:1604 HOSPITAL PKWY STE 407
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6932
Practice Address - Country:US
Practice Address - Phone:972-573-3855
Practice Address - Fax:833-973-4597
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXV04652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program