Healthcare Provider Details

I. General information

NPI: 1093195455
Provider Name (Legal Business Name): JOSE GARZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 N MCCOLL RD APT. 925
MCALLEN TX
78501-9105
US

IV. Provider business mailing address

3801 N MCCOLL RD APT. 925
MCALLEN TX
78501-9105
US

V. Phone/Fax

Practice location:
  • Phone: 956-292-4488
  • Fax:
Mailing address:
  • Phone: 956-292-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number57990
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number57990
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: