Provider Demographics
NPI:1851683957
Name:DE LA GARZA, LYDIA VERONICA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:VERONICA
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 N BORDER AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-3603
Mailing Address - Country:US
Mailing Address - Phone:956-373-4683
Mailing Address - Fax:
Practice Address - Street 1:1701 N BORDER AVE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-3603
Practice Address - Country:US
Practice Address - Phone:956-373-4683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29563171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator