Provider Demographics
NPI:1932507753
Name:GARZA, CARLOS (PTA)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BUSINESS DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-4499
Mailing Address - Country:US
Mailing Address - Phone:956-517-1235
Mailing Address - Fax:
Practice Address - Street 1:35 BUSINESS DR
Practice Address - Street 2:SUITE D
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4499
Practice Address - Country:US
Practice Address - Phone:956-517-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2039469225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant