MEDICARE: OSCAR O GARZA MS, ATC, CSCS

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	2255A2300X	Athletic Trainer	AT6785	TX

General Provider Information

NPI Number	:	1790481463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR O GARZA MS, ATC, CSCS

Provider Business Mailing Address
First Line	:	PO BOX 724
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-0724
Country	:	US
Telephone Number	:	956-844-4431
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 EL BRAZIL RANCH LN
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-6031
Country	:	US
Telephone Number	:	956-844-4431
Fax Number	:

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

Provider Enumeration Date	:	02/03/2023
Last Update Date	:	02/03/2023

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