Provider Demographics
NPI:1821399296
Name:GARZA, ERIC NOEL
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:NOEL
Last Name:GARZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 DEVON ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1926
Mailing Address - Country:US
Mailing Address - Phone:405-372-6100
Mailing Address - Fax:
Practice Address - Street 1:712 DEVON ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-1926
Practice Address - Country:US
Practice Address - Phone:405-372-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator