Provider Demographics
NPI:1689678575
Name:JAIME R. GARZA, M.D., D.D.S., P.A.
Entity Type:Organization
Organization Name:JAIME R. GARZA, M.D., D.D.S., P.A.
Other - Org Name:TEXAS PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:210-616-0301
Mailing Address - Street 1:21 SPURS LANE
Mailing Address - Street 2:STE 120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240
Mailing Address - Country:US
Mailing Address - Phone:210-616-0301
Mailing Address - Fax:210-616-0302
Practice Address - Street 1:21 SPURS LN
Practice Address - Street 2:STE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1634
Practice Address - Country:US
Practice Address - Phone:210-616-0301
Practice Address - Fax:210-616-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4926174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC16002Medicare UPIN
TX00467XMedicare ID - Type Unspecified