Healthcare Provider Details

I. General information

NPI: 1922007285
Provider Name (Legal Business Name): DAVID J DE LA GARZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 NE LOOP 286
PARIS TX
75460-5002
US

IV. Provider business mailing address

3435 NE LOOP 286
PARIS TX
75460-5002
US

V. Phone/Fax

Practice location:
  • Phone: 903-737-0000
  • Fax: 903-785-1135
Mailing address:
  • Phone: 903-737-0000
  • Fax: 903-785-1135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberK8109
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: