Healthcare Provider Details

I. General information

NPI: 1205149796
Provider Name (Legal Business Name): ROSEMARY GARZA CHRISTY, MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5527 WENONAH DR
DALLAS TX
75209-5521
US

IV. Provider business mailing address

PO BOX 7407
DALLAS TX
75209
US

V. Phone/Fax

Practice location:
  • Phone: 214-350-1923
  • Fax: 214-350-5160
Mailing address:
  • Phone: 214-350-1923
  • Fax: 214-350-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberF6652
License Number StateTX

VIII. Authorized Official

Name: ROSEMARY GARZA CHRISTY
Title or Position: PRESIDENT
Credential: MD
Phone: 214-350-1923