Provider Demographics
NPI:1821072323
Name:GARZA, JUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1100 WILFORD HALL LOOP, BLDG 4554
Mailing Address - Street 2:ATTN: 59 MDW/SGHC
Mailing Address - City:JBSA LACKLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78236-9908
Mailing Address - Country:US
Mailing Address - Phone:210-292-6225
Mailing Address - Fax:210-292-7868
Practice Address - Street 1:1100 WILFORD HALL LOOP, BLDG 4554
Practice Address - Street 2:ATTN: 59 MDW/SGHC
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-292-6225
Practice Address - Fax:210-292-7868
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2018-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA023976171000000X, 174400000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No171000000XOther Service ProvidersMilitary Health Care Provider
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXVAD000Medicare UPIN