Provider Demographics
NPI:1083147987
Name:GARZA, ANTHONY GALATEO (LPC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:GALATEO
Last Name:GARZA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-1703
Mailing Address - Country:US
Mailing Address - Phone:432-934-2026
Mailing Address - Fax:
Practice Address - Street 1:1909 W WALL ST STE A
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6570
Practice Address - Country:US
Practice Address - Phone:432-653-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional