Provider Demographics
NPI:1073757688
Name:GARZA-VICKERY, MONICA NICOLE (LM, NARM CPM)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:NICOLE
Last Name:GARZA-VICKERY
Suffix:
Gender:F
Credentials:LM, NARM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14080 NACOGDOCHES RD # 542
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1944
Mailing Address - Country:US
Mailing Address - Phone:210-262-7201
Mailing Address - Fax:612-545-2475
Practice Address - Street 1:12830 TARRYTOWN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4628
Practice Address - Country:US
Practice Address - Phone:210-262-7201
Practice Address - Fax:612-545-2475
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99068176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife