1215329602 NPI number — RICARDO A GARZA MD PLLC

Table of content: (NPI 1215329602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215329602 NPI number — RICARDO A GARZA MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICARDO A GARZA MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215329602
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6800 W IH 10
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78201-2038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-6391
Provider Business Mailing Address Fax Number:
210-616-3327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6800 W IH 10 WEST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78201-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-6391
Provider Business Practice Location Address Fax Number:
210-616-3327
Provider Enumeration Date:
02/23/2015

Additional Information

Authorized Official

Authorized Official Last Name:
GARZA
Authorized Official First Name:
RICARDO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
210-614-6391

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  G8125 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 405098 . This is a "PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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