Healthcare Provider Details

I. General information

NPI: 1639567944
Provider Name (Legal Business Name): JOSHUA GARZA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 GLOVER RD STE 4
SIDNEY NE
69162-3050
US

IV. Provider business mailing address

610 GLOVER RD STE 4
SIDNEY NE
69162-3050
US

V. Phone/Fax

Practice location:
  • Phone: 308-254-4752
  • Fax: 308-254-7257
Mailing address:
  • Phone: 308-254-4752
  • Fax: 308-254-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1879
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: