Provider Demographics
NPI:1003606823
Name:DE LA GARZA, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:BUSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1400 PRESTON RD STE 260
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5183
Mailing Address - Country:US
Mailing Address - Phone:214-396-3960
Mailing Address - Fax:214-396-3962
Practice Address - Street 1:1400 PRESTON RD STE 260
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5183
Practice Address - Country:US
Practice Address - Phone:214-396-3960
Practice Address - Fax:214-396-3962
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist