MEDICARE: OMAR D GARZA, OD, PA

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	152W00000X	Optometrist	5979T	TX

General Provider Information

NPI Number	:	1952590580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMAR D GARZA, OD, PA

Provider Business Mailing Address
First Line	:	PO BOX 23007
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-0007
Country	:	US
Telephone Number	:	210-533-0101
Fax Number	:	210-533-9292

Provider Business Practice Location Address
First Line	:	1343 FAIR AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-1437
Country	:	US
Telephone Number	:	210-533-0101
Fax Number	:	210-533-9292

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. OMAR D GARZA
Credential	:	O.D.
Telephone Number	:	210-846-3252

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	06/30/2014

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