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NPI Code Detail

MEDICARE: JOSE A GARZA JR.

MEDICARE: JOSE A GARZA JR.
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
1246ZS0410XSurgical Technologist510922TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1510922OTHERTXCERTIFIED SURGICAL TECH

General Provider Information

NPI Number : 1841310513
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE A GARZA JR.
Provider Business Mailing Address
First Line : 1005 LA FONTANA
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75052-5456
Country : US
Telephone Number : 469-733-6751
Fax Number :
Provider Business Practice Location Address
First Line : 10400 N CENTRAL EXPY
Second Line :
City : DALLAS
State : TX
Zip : 75231-2297
Country : US
Telephone Number : 469-733-6751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 03/16/2021

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