MEDICARE: STEPHANIE DE LA GARZA MS

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	101YP2500X	Professional Counselor	96413	TX

General Provider Information

NPI Number	:	1184448342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE DE LA GARZA MS

Provider Business Mailing Address
First Line	:	3418 HIGHWAY 6 S STE B266
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-4206
Country	:	US
Telephone Number	:	713-482-1985
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 HIGHWAY 6 S STE B266
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-4206
Country	:	US
Telephone Number	:	713-482-1985
Fax Number	:

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

Provider Enumeration Date	:	11/13/2024
Last Update Date	:	11/13/2024

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