MEDICARE: DR. MARIO A 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	207RG0100X	Gastroenterology Physician	K7743	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8J8381	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194719666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIO A GARZA M.D.

Provider Business Mailing Address
First Line	:	8415 DATAPOINT DR STE 700
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3327
Country	:	US
Telephone Number	:	210-614-1234
Fax Number	:	210-614-0952

Provider Business Practice Location Address
First Line	:	855 PROTON RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4203
Country	:	US
Telephone Number	:	210-614-1234
Fax Number	:	210-614-0952

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	03/17/2018

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