Healthcare Provider Details

I. General information

NPI: 1427001510
Provider Name (Legal Business Name): JOANNA GARZA MARTINEZ PA C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNA GARZA PAC

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13407 EMERALD SKIES WAY
HORIZON CITY TX
79928-6462
US

IV. Provider business mailing address

13407 EMERALD SKIES WAY
HORIZON CITY TX
79928-6462
US

V. Phone/Fax

Practice location:
  • Phone: 915-252-9910
  • Fax:
Mailing address:
  • Phone: 915-252-9910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20020032
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA02576
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: