Provider Demographics
NPI:1467005082
Name:GARZA, ALYSSA R (OD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:R
Last Name:GARZA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4903
Mailing Address - Country:US
Mailing Address - Phone:956-682-2141
Mailing Address - Fax:956-682-9484
Practice Address - Street 1:505 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4903
Practice Address - Country:US
Practice Address - Phone:956-682-2141
Practice Address - Fax:956-682-9484
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9700T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist