Provider Demographics
NPI:1912557844
Name:GARZA, GABRIELA MARIE
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:MARIE
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GABRIELA
Other - Middle Name:MARIE
Other - Last Name:BECERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10160 WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:KS
Mailing Address - Zip Code:66018-7996
Mailing Address - Country:US
Mailing Address - Phone:913-687-3691
Mailing Address - Fax:
Practice Address - Street 1:1130 W 4TH ST STE 3204
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1345
Practice Address - Country:US
Practice Address - Phone:785-505-5815
Practice Address - Fax:785-505-5278
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant