MEDICARE: CARLA LEYDA GARZA AGNP-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	363L00000X	Nurse Practitioner	AP130782	TX

General Provider Information

NPI Number	:	1528417029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA LEYDA GARZA AGNP-C

Provider Business Mailing Address
First Line	:	2502 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-1523
Country	:	US
Telephone Number	:	713-224-0555
Fax Number	:

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

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	07/05/2016

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