Provider Demographics
NPI:1558712315
Name:GARZA, MONICA GUADALUPE
Entity Type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:GUADALUPE
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-3801
Mailing Address - Country:US
Mailing Address - Phone:806-340-3621
Mailing Address - Fax:
Practice Address - Street 1:1515 BIRCH ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-3801
Practice Address - Country:US
Practice Address - Phone:806-340-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4400297369376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide