Provider Demographics
NPI:1366646036
Name:RAYMUND GARZA OD PC
Entity Type:Organization
Organization Name:RAYMUND GARZA OD PC
Other - Org Name:ALICE FAMILY EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:RAYMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-668-3937
Mailing Address - Street 1:PO BOX 1698
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78333-1698
Mailing Address - Country:US
Mailing Address - Phone:361-668-3937
Mailing Address - Fax:
Practice Address - Street 1:777 N TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-3883
Practice Address - Country:US
Practice Address - Phone:361-668-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05244TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00009SMedicare PIN