Provider Demographics
NPI:1679176184
Name:GARZA, JAVIER GUSTAVO (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:GUSTAVO
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 1:2300 N CONWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-2345
Mailing Address - Country:US
Mailing Address - Phone:956-424-0591
Mailing Address - Fax:
Practice Address - Street 1:2300 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-2345
Practice Address - Country:US
Practice Address - Phone:956-424-0591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist