Provider Demographics
NPI:1144416421
Name:GARZA, JOYCELYN GARCIA (OD)
Entity Type:Individual
Prefix:DR
First Name:JOYCELYN
Middle Name:GARCIA
Last Name:GARZA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOYCE
Other - Middle Name:GARCIA
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1200 E CAMPBELL RD STE 108
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-1963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1503 SW LOOP 410 STE 113
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1681
Practice Address - Country:US
Practice Address - Phone:210-675-1515
Practice Address - Fax:210-599-7574
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5123TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188647501Medicaid
TX8F6076Medicare PIN
TX188647501Medicaid