Provider Demographics
NPI:1770685984
Name:GARZA, VILMA (CNMS)
Entity Type:Individual
Prefix:
First Name:VILMA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:CNMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-1013
Mailing Address - Country:US
Mailing Address - Phone:210-233-7000
Mailing Address - Fax:210-277-6387
Practice Address - Street 1:3066 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220-1013
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:210-277-6387
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX547407367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090033403Medicaid
TX090033403Medicaid