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NPI Code Detail

MEDICARE: HECTOR GARZA CENTER

MEDICARE: HECTOR GARZA CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number : 1043472681
Entity Type Code : Organization
Provider Name (Legal Business Name) : HECTOR GARZA CENTER
Provider Business Mailing Address
First Line : 620 E AFTON OAKS BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-1236
Country : US
Telephone Number : 210-568-8600
Fax Number : 210-490-9430
Provider Business Practice Location Address
First Line : 620 E AFTON OAKS BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-1236
Country : US
Telephone Number : 210-568-8600
Fax Number : 210-490-9430
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MISS MICHELLE ANN MARTENSON
Credential :
Telephone Number : 210-568-8600
Provider Enumeration Date : 06/25/2008
Last Update Date : 06/25/2008

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Directions to “HECTOR GARZA CENTER ” Practice Location

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