Provider Demographics
NPI:1851101661
Name:GARZA, MELISSA MARIE (CHW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:GARZA
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 KRAMER LN STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4196
Mailing Address - Country:US
Mailing Address - Phone:512-978-9485
Mailing Address - Fax:
Practice Address - Street 1:6425 SOUTH I 35 FRONTAGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744
Practice Address - Country:US
Practice Address - Phone:512-978-9485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14182172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker