Healthcare Provider Details

I. General information

NPI: 1235332529
Provider Name (Legal Business Name): EMILY L GARZA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 HIGDON FERRY RD STE B
HOT SPRINGS AR
71913-6456
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-2731
  • Fax: 501-623-1660
Mailing address:
  • Phone: 239-432-8331
  • Fax: 813-321-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-408
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: