Provider Demographics
NPI:1639173982
Name:GARZA, JORGE ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ALBERTO
Last Name:GARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13103 HUNTERS FOX ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2023
Mailing Address - Country:US
Mailing Address - Phone:210-224-4661
Mailing Address - Fax:210-224-8801
Practice Address - Street 1:3326 SE MILITARY DR STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3984
Practice Address - Country:US
Practice Address - Phone:210-304-8282
Practice Address - Fax:210-224-8801
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5444208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118104206Medicaid
TXF12722Medicare UPIN