Provider Demographics
NPI:1033765102
Name:GARZA, MANUEL (PTA)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23726 MORNING FOG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7273
Mailing Address - Country:US
Mailing Address - Phone:210-380-8159
Mailing Address - Fax:210-599-4088
Practice Address - Street 1:23726 MORNING FOG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7273
Practice Address - Country:US
Practice Address - Phone:210-380-8159
Practice Address - Fax:210-599-4088
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2039832225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant