Provider Demographics
NPI:1417484361
Name:GARZA, TONYA LEE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:LEE
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 CELESTIA PL
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3622
Mailing Address - Country:US
Mailing Address - Phone:509-525-1395
Mailing Address - Fax:
Practice Address - Street 1:1872 CELESTIA PL
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3622
Practice Address - Country:US
Practice Address - Phone:509-525-1395
Practice Address - Fax:509-525-1395
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty