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General NPI Number Information
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NPI Number | 1609864503
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Entity Type | Organization
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Legal Business Name | JAIME (JIM) RENE GARZA
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4302 S SUGAR RD SUITE 200
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City | EDINBURG
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State | TX
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Zip | 78539-7073
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Country | US
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Telephone | 956-383-4988
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Fax | 956-383-5096
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Provider Business Mailing Address
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Address Line | 4302 S SUGAR RD SUITE 200
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City | EDINBURG
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State | TX
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Zip | 78539-7073
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Country | US
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Telephone | 956-383-4988
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Fax | 956-383-5096
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Authorized Official
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Title or Position | OWNER
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Name | JAIME (JIM) RENE GARZA
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Credential | MD
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Telephone | 956-383-4988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | H1868
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License Number State | TX
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