Provider Demographics
NPI:1467890467
Name:GARZA, KRISTOPHER KARL
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:KARL
Last Name:GARZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 COSNER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3139
Mailing Address - Country:US
Mailing Address - Phone:361-693-5694
Mailing Address - Fax:
Practice Address - Street 1:5115 COSNER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-3139
Practice Address - Country:US
Practice Address - Phone:361-693-5694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health