MEDICARE: RAYMUND GARZA O.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	152W00000X	Optometrist	5244TG	TX

General Provider Information

NPI Number	:	1356423180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMUND GARZA O.D.

Provider Business Mailing Address
First Line	:	5425 S PADRE ISLAND DR
Second Line	:	# 135-A
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-5301
Country	:	US
Telephone Number	:	361-980-3937
Fax Number	:	361-980-0394

Provider Business Practice Location Address
First Line	:	5425 S PADRE ISLAND DR
Second Line	:	# 135-A
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-5301
Country	:	US
Telephone Number	:	361-980-3937
Fax Number	:	361-980-0394

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	01/10/2008

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