Provider Demographics
NPI:1013900497
Name:GARZA, PABLO (MD)
Entity Type:Individual
Prefix:
First Name:PABLO
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2644
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77902-2644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2806 N NAVARRO ST
Practice Address - Street 2:SUITE D
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3905
Practice Address - Country:US
Practice Address - Phone:361-576-2108
Practice Address - Fax:361-576-2277
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6365207Q00000X, 207N00000X, 207PE0004X, 207VG0400X, 207VX0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics