MEDICARE: DR. MARTIN GARZA M.D.

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
1	208000000X	Pediatrics Physician	L0194	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8K0400	OTHER	TX	BLUECROSS PROVIDER ID

General Provider Information

NPI Number	:	1124078746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN GARZA M.D.

Provider Business Mailing Address
First Line	:	3521 W FREDDY GONZALEZ DR
Second Line	:	SUITE B
City	:	EDINBURG
State	:	TX
Zip	:	78539-7339
Country	:	US
Telephone Number	:	956-287-2100
Fax Number	:	956-287-2111

Provider Business Practice Location Address
First Line	:	3521 W FREDDY GONZALEZ DR
Second Line	:	SUITE B
City	:	EDINBURG
State	:	TX
Zip	:	78539-7339
Country	:	US
Telephone Number	:	956-287-2100
Fax Number	:	956-287-2111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	04/21/2017

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