Healthcare Provider Details
I. General information
NPI: 1649344524
Provider Name (Legal Business Name): AMANDO FRANCISCO GARZA III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1519 E BUSTAMANTE ST STE A
LAREDO TX
78041-5305
US
IV. Provider business mailing address
1519 E BUSTAMANTE ST STE A
LAREDO TX
78041-5305
US
V. Phone/Fax
- Phone: 956-722-7872
- Fax: 956-722-5813
- Phone: 956-722-7872
- Fax: 956-722-5813
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | H2848 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080A0000X |
| Taxonomy | Pediatric Adolescent Medicine Physician |
| License Number | H4828 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | H4828 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: