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General NPI Number Information
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NPI Number | 1790890887
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Entity Type | Organization
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Legal Business Name | ELISA GARZA INC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2969 SOUTHMOST RD SUITE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-982-3995
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Fax | 956-542-1711
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Provider Business Mailing Address
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Address Line | 2969 SOUTHMOST RD SUITE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-982-3995
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Fax | 956-542-1711
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MRS. MARIA ELISA ROSALES
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Credential | CERTIFIED OPTICIAN
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Telephone | 956-982-3995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 061763
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License Number State | TX
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