Provider Demographics
NPI:1528403342
Name:GARZA, JAMIE FRUGIA (RN, NP)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:FRUGIA
Last Name:GARZA
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 TEMPE ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4595
Mailing Address - Country:US
Mailing Address - Phone:832-628-0409
Mailing Address - Fax:
Practice Address - Street 1:215 E EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3820
Practice Address - Country:US
Practice Address - Phone:281-992-5914
Practice Address - Fax:281-992-5916
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX705517363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120293OtherMEDICARE PROVIDER NUMBER