Provider Demographics
NPI:1578615472
Name:NOEL O. GARZA,D.D.S., P.A
Entity Type:Organization
Organization Name:NOEL O. GARZA,D.D.S., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERDENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-580-4700
Mailing Address - Street 1:1916 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3106
Mailing Address - Country:US
Mailing Address - Phone:956-580-4700
Mailing Address - Fax:956-580-4710
Practice Address - Street 1:1916 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3106
Practice Address - Country:US
Practice Address - Phone:956-580-4700
Practice Address - Fax:956-580-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186731223G0001X
TX176371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60175-01OtherTEXAS CHIP PROGRAM