Healthcare Provider Details

I. General information

NPI: 1114899895
Provider Name (Legal Business Name): BIANCA GARZA RN,IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 E PALM CIR
MISSION TX
78574-2407
US

IV. Provider business mailing address

2315 E PALM CIR
MISSION TX
78574-2407
US

V. Phone/Fax

Practice location:
  • Phone: 956-600-3912
  • Fax:
Mailing address:
  • Phone: 956-600-3912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL87731
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: