Provider Demographics
NPI:1447584263
Name:GARZA, MIGUEL E (MS, OTR)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:E
Last Name:GARZA
Suffix:
Gender:M
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W FERGUSON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-2455
Mailing Address - Country:US
Mailing Address - Phone:956-258-5073
Mailing Address - Fax:956-258-5333
Practice Address - Street 1:208 W FERGUSON ST STE 3
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2455
Practice Address - Country:US
Practice Address - Phone:956-258-5073
Practice Address - Fax:956-258-5333
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112288225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206654004Medicaid
TX206654009Medicaid