Provider Demographics
NPI:1174642698
Name:JUAN JOEL GARZA, MD PA
Entity Type:Organization
Organization Name:JUAN JOEL GARZA, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:NORMALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-430-3413
Mailing Address - Street 1:500 E. RIDGE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503
Mailing Address - Country:US
Mailing Address - Phone:956-630-5522
Mailing Address - Fax:956-926-4350
Practice Address - Street 1:2310 N. ED CAREY DRIVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-428-5522
Practice Address - Fax:956-926-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7157207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00311777OtherMEDICARE RR
TX00838JMedicare ID - Type Unspecified
TXH05465Medicare UPIN