Provider Demographics
NPI:1780451997
Name:GARZA, LAURA ANNE (PTA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:GARZA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANNE
Other - Last Name:PANTOJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:10114 AMBER FLORA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3255
Mailing Address - Country:US
Mailing Address - Phone:210-564-5681
Mailing Address - Fax:
Practice Address - Street 1:5100 JOHN D RYAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3527
Practice Address - Country:US
Practice Address - Phone:210-568-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant