Provider Demographics
NPI:1760962336
Name:GARZA, GABRIELLE MARCELLA (MS , CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:MARCELLA
Last Name:GARZA
Suffix:
Gender:F
Credentials:MS , CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 N BRAESWOOD BLVD APT 419
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-2869
Mailing Address - Country:US
Mailing Address - Phone:956-432-1590
Mailing Address - Fax:
Practice Address - Street 1:106 KAHN ST
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-2177
Practice Address - Country:US
Practice Address - Phone:361-798-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist