Provider Demographics
NPI:1275728909
Name:JAVIER O. DE LA GARZA, DDS, PA
Entity Type:Organization
Organization Name:JAVIER O. DE LA GARZA, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:O
Authorized Official - Last Name:DE LA GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-968-8713
Mailing Address - Street 1:901 E 6TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6449
Mailing Address - Country:US
Mailing Address - Phone:956-968-8713
Mailing Address - Fax:956-973-9649
Practice Address - Street 1:901 E 6TH ST STE 2
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6449
Practice Address - Country:US
Practice Address - Phone:956-968-8713
Practice Address - Fax:956-973-9649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty