Provider Demographics
NPI:1598398554
Name:GARZA, DANIEL ANDRES (PTA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANDRES
Last Name:GARZA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7629 LINKMEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3031
Mailing Address - Country:US
Mailing Address - Phone:210-779-5508
Mailing Address - Fax:
Practice Address - Street 1:4917 RAVENSWOOD DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-4317
Practice Address - Country:US
Practice Address - Phone:210-673-2761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2095822225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant