Provider Demographics
NPI:1750577995
Name:GARZA, JOSE E (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:E
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 1:6416 OLD WINTER GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-1348
Mailing Address - Country:US
Mailing Address - Phone:407-447-7121
Mailing Address - Fax:
Practice Address - Street 1:5104 HARRISBURG BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4202
Practice Address - Country:US
Practice Address - Phone:832-667-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1308207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX289039401Medicaid
TXP1308OtherMEDICAL LICENSE
TX289039401Medicaid
TXG0184899OtherDPS
TXFG0522563OtherDEA
TX289039401Medicaid