MEDICARE: CARLOS ALFREDO GARZA-MEDRANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	90013	TX
2	101YP2500X	Professional Counselor	90013	TX

General Provider Information

NPI Number	:	1396578555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS ALFREDO GARZA-MEDRANO

Provider Business Mailing Address
First Line	:	2617 SCOTSWOOD DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-2554
Country	:	US
Telephone Number	:	469-579-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	9209 ELAM RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75217-4179
Country	:	US
Telephone Number	:	469-780-2211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	11/10/2025

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Directions to “ CARLOS ALFREDO GARZA-MEDRANO ” Practice Location

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