MEDICARE: MRS. IDA MARIE GARZA NP

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	1114123	TX

General Provider Information

NPI Number	:	1992409007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. IDA MARIE GARZA NP

Provider Business Mailing Address
First Line	:	7909 FREDERICKSBURG RD STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3400
Country	:	US
Telephone Number	:	210-286-3048
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 SUNDANCE PKWY STE A1
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-2771
Country	:	US
Telephone Number	:	830-246-2115
Fax Number	:	830-730-4127

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

Provider Enumeration Date	:	03/30/2023
Last Update Date	:	04/17/2025

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