Healthcare Provider Details

I. General information

NPI: 1255531695
Provider Name (Legal Business Name): MARIA OLIVIA GARZA R.D., L.D.,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 EBONY LN
MISSION TX
78572-2944
US

IV. Provider business mailing address

307 EBONY LN
MISSION TX
78572-2944
US

V. Phone/Fax

Practice location:
  • Phone: 956-585-1413
  • Fax:
Mailing address:
  • Phone: 956-585-1413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number802617
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number802617
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: