Healthcare Provider Details

I. General information

NPI: 1689608432
Provider Name (Legal Business Name): MARCO G GARZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S FRY RD
KATY TX
77450-2255
US

IV. Provider business mailing address

3560 DELAWARE ST STE 601A
BEAUMONT TX
77706-3060
US

V. Phone/Fax

Practice location:
  • Phone: 281-599-5783
  • Fax:
Mailing address:
  • Phone: 409-924-9666
  • Fax: 409-924-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberL5340
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: