Provider Demographics
NPI:1356423180
Name:GARZA, RAYMUND (OD)
Entity type:Individual
Prefix:
First Name:RAYMUND
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 S PADRE ISLAND DR
Mailing Address - Street 2:# 135-A
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5301
Mailing Address - Country:US
Mailing Address - Phone:361-980-3937
Mailing Address - Fax:361-980-0394
Practice Address - Street 1:5425 S PADRE ISLAND DR
Practice Address - Street 2:# 135-A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5301
Practice Address - Country:US
Practice Address - Phone:361-980-3937
Practice Address - Fax:361-980-0394
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5244TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU62827Medicare UPIN
TX8A1046Medicare PIN
TX83059EMedicare PIN