Provider Demographics
NPI:1609430586
Name:GARZA, RENE FAUSTINO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:FAUSTINO
Last Name:GARZA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W WILLIAM CANNON DR STE 203
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5255
Mailing Address - Country:US
Mailing Address - Phone:512-707-2300
Mailing Address - Fax:512-707-2378
Practice Address - Street 1:2501 W WILLIAM CANNON DR STE 203
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5255
Practice Address - Country:US
Practice Address - Phone:512-707-2300
Practice Address - Fax:512-707-2378
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist