Provider Demographics
NPI:1619945441
Name:GARZA, CARLOS (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 OLDS ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-9477
Mailing Address - Country:US
Mailing Address - Phone:517-849-0000
Mailing Address - Fax:517-849-2631
Practice Address - Street 1:735 OLDS ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-9477
Practice Address - Country:US
Practice Address - Phone:517-849-0000
Practice Address - Fax:517-849-2631
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4421931Medicaid
MI950C06053OtherBCBS
MI0C06053006Medicare ID - Type Unspecified
MI950C06053OtherBCBS