Provider Demographics
NPI:1255375572
Name:HAMONS GARZA, TERRI (RD)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:HAMONS GARZA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:21195 W INTERSTATE 10
Mailing Address - Street 2:SUITE 2101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1674
Mailing Address - Country:US
Mailing Address - Phone:210-687-1144
Mailing Address - Fax:210-687-1146
Practice Address - Street 1:21195 W INTERSTATE 10
Practice Address - Street 2:SUITE 2101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1674
Practice Address - Country:US
Practice Address - Phone:210-687-1144
Practice Address - Fax:210-687-1146
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06530133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162150001Medicaid