MEDICARE: LETICIA GARZA

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	235Z00000X	Speech-Language Pathologist	110137	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110137	OTHER	TX	CCC-SLP

General Provider Information

NPI Number	:	1578842654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LETICIA GARZA

Provider Business Mailing Address
First Line	:	5040 VERDOME LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-4222
Country	:	US
Telephone Number	:	830-421-6624
Fax Number	:

Provider Business Practice Location Address
First Line	:	9220 KIRBY DR
Second Line	:	SUITE 1000
City	:	HOUSTON
State	:	TX
Zip	:	77054-2533
Country	:	US
Telephone Number	:	713-383-9700
Fax Number	:

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

Provider Enumeration Date	:	08/08/2011
Last Update Date	:	06/02/2016

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Directions to “ LETICIA GARZA ” Practice Location

Language	Start Address	Practice Location

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