MEDICARE: PHILIP GARZA RODRIGUEZ F.N.P., D.C.

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	111N00000X	Chiropractor	6478	TX
2	363LF0000X	Family Nurse Practitioner	AP129266	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP129266	OTHER	TX	NURSE PRACTIONER LICENSE

General Provider Information

NPI Number	:	1407982135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP GARZA RODRIGUEZ F.N.P., D.C.

Provider Business Mailing Address
First Line	:	PO BOX 80410
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76244-2906
Country	:	US
Telephone Number	:	817-770-6867
Fax Number	:	214-260-6062

Provider Business Practice Location Address
First Line	:	1201 N WATSON RD STE 166
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6223
Country	:	US
Telephone Number	:	817-770-6867
Fax Number	:	214-260-6062

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	11/17/2022

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