Provider Demographics
NPI:1588111736
Name:GARZA, LYENA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LYENA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10304 N 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6333
Mailing Address - Country:US
Mailing Address - Phone:956-607-8769
Mailing Address - Fax:
Practice Address - Street 1:10304 N 25TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6333
Practice Address - Country:US
Practice Address - Phone:956-607-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102077235Z00000X
CA24780235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist