Provider Demographics
NPI:1528226396
Name:GARZA, TRINI JON (MD)
Entity Type:Individual
Prefix:
First Name:TRINI
Middle Name:JON
Last Name:GARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 10TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-3178
Mailing Address - Country:US
Mailing Address - Phone:830-393-1400
Mailing Address - Fax:830-393-1633
Practice Address - Street 1:497 10TH ST STE 101
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-3178
Practice Address - Country:US
Practice Address - Phone:830-393-1400
Practice Address - Fax:830-393-1633
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX286424104Medicaid
TX358179ZHRUOtherMEDICARE PTAN