Provider Demographics
NPI:1689300964
Name:DE LA GARZA, ASTRID ANABELY (PA-C)
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:ANABELY
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 FLORA AVE
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-3568
Mailing Address - Country:US
Mailing Address - Phone:956-566-8490
Mailing Address - Fax:
Practice Address - Street 1:110 E SAVANNAH AVE BLDG A204
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1239
Practice Address - Country:US
Practice Address - Phone:956-686-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine