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NPI Code Detail

MEDICARE: MARISSA NICOLE GARZA N/A

MEDICARE: MARISSA NICOLE GARZA N/A
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1376352567
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA NICOLE GARZA N/A
Provider Business Mailing Address
First Line : 6914 BRISBANE CT STE 200
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4924
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4501 MAGNOLIA COVE DR STE 106A
Second Line :
City : KINGWOOD
State : TX
Zip : 77345-2369
Country : US
Telephone Number : 844-272-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2025
Last Update Date : 01/02/2025

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Directions to “ MARISSA NICOLE GARZA N/A” Practice Location

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