Provider Demographics
NPI:1720669930
Name:GARZA, RUBEN N (LPC-ASSOCIATE, LCDC)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:N
Last Name:GARZA
Suffix:
Gender:M
Credentials:LPC-ASSOCIATE, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12404 CIELO GRANDE ST
Mailing Address - Street 2:
Mailing Address - City:DEL VALLE
Mailing Address - State:TX
Mailing Address - Zip Code:78617-3664
Mailing Address - Country:US
Mailing Address - Phone:512-791-0348
Mailing Address - Fax:
Practice Address - Street 1:314 E HIGHLAND MALL BLVD STE 301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3731
Practice Address - Country:US
Practice Address - Phone:512-444-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14885101YA0400X
TX84345101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty