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General NPI Number Information
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NPI Number | 1497108989
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Entity Type | Individual
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Provider Name | NANCY GARZA PTA
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 305 NE LOOP 820 BUSINESS TOWER 1 SUIT 200
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City | HURST
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State | TX
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Zip | 76053-7209
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Country | US
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Telephone | 817-292-8787
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Fax | 817-789-6849
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Provider Business Mailing Address
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Address Line | 1218 N MORENO AVE
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City | LAREDO
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State | TX
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Zip | 78043-3542
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2064031
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License Number State | TX
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