Healthcare Provider Details

I. General information

NPI: 1932335890
Provider Name (Legal Business Name): PHILLIP GARZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3367 S MERCY RD STE 207
GILBERT AZ
85297-7604
US

IV. Provider business mailing address

3367 S MERCY RD STE 207
GILBERT AZ
85297-7604
US

V. Phone/Fax

Practice location:
  • Phone: 480-855-5900
  • Fax: 480-855-9171
Mailing address:
  • Phone: 480-855-5900
  • Fax: 480-855-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number51082
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number51259
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: