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General NPI Number Information
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NPI Number | 1881721488
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Entity Type | Individual
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Provider Name | FERNANDO JOSE GARZA RSA
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 228 W LINCOLN HIGHWAY 30 # 127 #127
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City | SCHEREVILLE
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State | IN
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Zip | 46375
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Country | US
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Telephone | 630-291-8614
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Fax | 630-216-1105
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Provider Business Mailing Address
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Address Line | 7146 183RD ST # 111
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City | TINLEY PARK
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State | IL
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Zip | 60477-3933
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Country | US
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Telephone | 630-750-0792
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 238.000017
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 238.000017
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License Number State | IL
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