Provider Demographics
NPI:1528531290
Name:GARZA, MISTY ELAINE (RN, NNP)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:ELAINE
Last Name:GARZA
Suffix:
Gender:F
Credentials:RN, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8307
Mailing Address - Country:US
Mailing Address - Phone:979-240-9967
Mailing Address - Fax:
Practice Address - Street 1:13030 HUNTERS BREEZE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2811
Practice Address - Country:US
Practice Address - Phone:210-387-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-05
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX713137163WN0002X
TXAP141067363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care