Provider Demographics
NPI:1073710984
Name:CABELLO GARZA, JAVIER A (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:A
Last Name:CABELLO GARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PEASE STREET
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-389-6565
Mailing Address - Fax:956-389-6567
Practice Address - Street 1:2101 PEASE STREET
Practice Address - Street 2:SUITE 1G
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-389-6565
Practice Address - Fax:956-389-6567
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3296207RC0200X
MN49941207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX311448001Medicaid
TX342600888OtherMEDICARE PTAN
MN557622100Medicaid
MN557622100Medicaid