Provider Demographics
NPI:1780245845
Name:GARZA, HERALDO REJINO (RPH)
Entity type:Individual
Prefix:
First Name:HERALDO
Middle Name:REJINO
Last Name:GARZA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S 1ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1295
Mailing Address - Country:US
Mailing Address - Phone:956-686-3716
Mailing Address - Fax:957-631-0951
Practice Address - Street 1:1901 S 1ST ST STE 100
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1295
Practice Address - Country:US
Practice Address - Phone:956-686-3716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist