Healthcare Provider Details

I. General information

NPI: 1316632094
Provider Name (Legal Business Name): LORENA GARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20328 FM 2252
SAN ANTONIO TX
78266-2614
US

IV. Provider business mailing address

332 HARMON DR
SAN ANTONIO TX
78209-4830
US

V. Phone/Fax

Practice location:
  • Phone: 210-901-9082
  • Fax:
Mailing address:
  • Phone: 512-202-7872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM08537
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: