Healthcare Provider Details

I. General information

NPI: 1629351267
Provider Name (Legal Business Name): OZIEL GARZA JR SA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 FLORAL RIDGE DR
SPRING TX
77388-5377
US

IV. Provider business mailing address

2510 FLORAL RIDGE DR
SPRING TX
77388-5377
US

V. Phone/Fax

Practice location:
  • Phone: 281-353-1809
  • Fax: 281-353-1809
Mailing address:
  • Phone: 281-353-1809
  • Fax: 281-353-1809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number11-163
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: