Provider Demographics
NPI:1275530768
Name:GARZA, ROLAND R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:R
Last Name:GARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 UNIVERSITY DR E
Mailing Address - Street 2:#100
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-2600
Mailing Address - Country:US
Mailing Address - Phone:979-846-1100
Mailing Address - Fax:979-260-9390
Practice Address - Street 1:1905 DOVE CROSSING
Practice Address - Street 2:#C
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868
Practice Address - Country:US
Practice Address - Phone:936-825-0000
Practice Address - Fax:936-825-8001
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2334207Q00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000951608Medicaid
TX1750470084OtherNPI CLINIC M
TX154467803Medicaid
TX1821185299OtherNPI AGENCY
TX187842302Medicaid
TX122167306Medicaid
TX1568519122OtherNPI CLINIC L
TX1275620551OtherNPI CLINIC R
TX1275726853OtherNPI CLINIC CS
TX1700973187OtherNPI CLINIC G
TX187842301Medicaid
TX741715140OtherTAX ID
TX000951607Medicaid
TX185649401Medicaid
TX451986Medicare Oscar/Certification
TX187842302Medicaid
TX451981Medicare Oscar/Certification
TX1275620551OtherNPI CLINIC R
TX741715140OtherTAX ID
TX122167306Medicaid
TX00316MMedicare PIN
TX1700973187OtherNPI CLINIC G