Provider Demographics
NPI:1497069330
Name:JESSICA GARZA
Entity Type:Organization
Organization Name:JESSICA GARZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:956-583-4309
Mailing Address - Street 1:2000 S MCCOLL RD
Mailing Address - Street 2:STE B # 204
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1516
Mailing Address - Country:US
Mailing Address - Phone:956-583-4309
Mailing Address - Fax:956-583-4311
Practice Address - Street 1:701 N AVASOLO ST STE F
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582
Practice Address - Country:US
Practice Address - Phone:956-583-4309
Practice Address - Fax:956-583-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220613802Medicaid
TX220613801Medicaid
TX220613801Medicaid