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General NPI Number Information
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NPI Number | 1265337257
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Entity Type | Organization
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Legal Business Name | STARGLADE THERAPY
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Dates
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Enumeration Date | 10/10/2026
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Last Update Date | 10/10/2026
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Provider Practice Location Address
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Address Line | 4006 SAINT PETER ST UNIT A
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City | SALADO
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State | TX
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Zip | 76571-2141
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Country | US
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Telephone | 512-763-2966
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Fax |
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Provider Business Mailing Address
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Address Line | 2112 SW H K DODGEN LOOP STE 183 PMB 1044
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City | TEMPLE
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State | TX
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Zip | 76504
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Country | US
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Telephone | 512-763-2966
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | AURICA GARZA
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Credential | LPC
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Telephone | 512-763-2966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | NULL
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