Provider Demographics
NPI:1598244188
Name:GARZA, JORGE JAVIER JR (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:JAVIER
Last Name:GARZA
Suffix:JR
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 E WHITEWING ST
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-8028
Mailing Address - Country:US
Mailing Address - Phone:956-844-9508
Mailing Address - Fax:
Practice Address - Street 1:1200 S BRYAN RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6840
Practice Address - Country:US
Practice Address - Phone:855-687-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112425235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist