Provider Demographics
NPI:1275962508
Name:CRETICIO-GARZA, MARIA IREN (MSN CPNP)
Entity Type:Individual
Prefix:MS
First Name:MARIA IREN
Middle Name:
Last Name:CRETICIO-GARZA
Suffix:
Gender:F
Credentials:MSN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1470
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-1470
Mailing Address - Country:US
Mailing Address - Phone:830-773-8917
Mailing Address - Fax:830-773-1892
Practice Address - Street 1:1175 EIDSON RD
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5403
Practice Address - Country:US
Practice Address - Phone:830-757-6946
Practice Address - Fax:830-757-5850
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124592363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20180741OtherPEDIATRIC NURSING CERTIFICATION BOARD