=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871481374
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLARISSA GARZA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 512 E EDINBURG AVE
-----------------------------------------------------
City | ELSA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78543-3007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-262-9719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 512 E EDINBURG AVE
-----------------------------------------------------
City | ELSA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78543-3007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-262-9719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183700000X
-----------------------------------------------------
Taxonomy Name | Pharmacy Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | 75944
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------