Provider Demographics
NPI:1679864813
Name:GARZA, KRYSTLE ANN (CCC, SLP)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:ANN
Last Name:GARZA
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 720157
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0157
Mailing Address - Country:US
Mailing Address - Phone:956-682-6900
Mailing Address - Fax:956-683-7192
Practice Address - Street 1:1002 W SAM HOUSTON BLVD STE 10
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5198
Practice Address - Country:US
Practice Address - Phone:956-702-9882
Practice Address - Fax:956-702-9886
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105877235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist