Provider Demographics
NPI:1487685293
Name:GARZA, JAIME RENE (MD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:RENE
Last Name:GARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5115 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8278
Mailing Address - Country:US
Mailing Address - Phone:956-683-7900
Mailing Address - Fax:956-683-9910
Practice Address - Street 1:5115 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8278
Practice Address - Country:US
Practice Address - Phone:956-683-7900
Practice Address - Fax:956-683-9910
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1868207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135391405Medicaid
TXE04437Medicare UPIN
TX80H727Medicare PIN