Provider Demographics
NPI:1689049959
Name:GARZA, KARAH DIANE (RN, CPNP - PC)
Entity Type:Individual
Prefix:
First Name:KARAH
Middle Name:DIANE
Last Name:GARZA
Suffix:
Gender:F
Credentials:RN, CPNP - PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4295 E FM 476
Mailing Address - Street 2:
Mailing Address - City:POTEET
Mailing Address - State:TX
Mailing Address - Zip Code:78065-4083
Mailing Address - Country:US
Mailing Address - Phone:210-913-7675
Mailing Address - Fax:
Practice Address - Street 1:109 N SMITH ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-4109
Practice Address - Country:US
Practice Address - Phone:830-281-8367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129810363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics