Provider Demographics
NPI:1831677574
Name:GARZA, PEDRO A (COTA)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:A
Last Name:GARZA
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:A
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:301 HANCOCK CT
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-5135
Mailing Address - Country:US
Mailing Address - Phone:956-898-2303
Mailing Address - Fax:
Practice Address - Street 1:301 HANCOCK CT
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-5135
Practice Address - Country:US
Practice Address - Phone:956-898-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215171224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant