Provider Demographics
NPI:1629637574
Name:GARZA, ALYSSA CELESTE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:CELESTE
Last Name:GARZA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S AUSTIN AVE UNIT 1145
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-5640
Mailing Address - Country:US
Mailing Address - Phone:737-225-8644
Mailing Address - Fax:
Practice Address - Street 1:501 S AUSTIN AVE UNIT 1145
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-5640
Practice Address - Country:US
Practice Address - Phone:737-225-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9677152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist