Provider Demographics
NPI:1225629330
Name:GARZA, LAURA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:GARZA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 DANVER LN
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107-3329
Mailing Address - Country:US
Mailing Address - Phone:317-786-5260
Mailing Address - Fax:401-652-1288
Practice Address - Street 1:2800 ENTERPRISE ST STE 5
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1106
Practice Address - Country:US
Practice Address - Phone:866-779-1696
Practice Address - Fax:401-652-1288
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018575A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist