Provider Demographics
NPI:1205373495
Name:HERNANDEZ GARZA, VERONICA
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:HERNANDEZ GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S SAINT MARYS ST # 200
Mailing Address - Street 2:
Mailing Address - City:FALFURRIAS
Mailing Address - State:TX
Mailing Address - Zip Code:78355-5025
Mailing Address - Country:US
Mailing Address - Phone:361-325-2910
Mailing Address - Fax:361-325-2519
Practice Address - Street 1:800 S SAINT MARYS ST # 200
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355-5025
Practice Address - Country:US
Practice Address - Phone:361-325-2910
Practice Address - Fax:361-325-2519
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist