1487854667 NPI number — AIMEE C GARZA MD

Table of content: AIMEE C GARZA MD (NPI 1487854667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487854667 NPI number — AIMEE C GARZA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARZA
Provider First Name:
AIMEE
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1487854667
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 797171
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75379-7171
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-494-4424
Provider Business Mailing Address Fax Number:
214-494-4423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 PARKWOOD BLVD
Provider Second Line Business Practice Location Address:
STE F100
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-7407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-494-4424
Provider Business Practice Location Address Fax Number:
214-494-4423
Provider Enumeration Date:
07/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  M6629 , 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: M6629 . This is a "STATE MEDICAL LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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