Provider Demographics
NPI:1467248807
Name:DE LA GARZA, MICHELLE ANNETTE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNETTE
Last Name:DE LA GARZA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5049
Mailing Address - Country:US
Mailing Address - Phone:956-314-2987
Mailing Address - Fax:
Practice Address - Street 1:2202 MULBERRY DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5049
Practice Address - Country:US
Practice Address - Phone:956-314-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139785163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse