Provider Demographics
NPI:1528720935
Name:GARZA, KIMBERLY ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:GARZA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:BUSHLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79012
Mailing Address - Country:US
Mailing Address - Phone:806-677-9795
Mailing Address - Fax:
Practice Address - Street 1:2400 WELLS ST
Practice Address - Street 2:
Practice Address - City:BUSHLAND
Practice Address - State:TX
Practice Address - Zip Code:79124-1189
Practice Address - Country:US
Practice Address - Phone:806-359-6683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist