Provider Demographics
NPI:1780612192
Name:GARZA, GILBERT A (MD)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:A
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 1:5170 US ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2004
Mailing Address - Country:US
Mailing Address - Phone:304-528-4600
Mailing Address - Fax:304-399-0015
Practice Address - Street 1:2900 1ST AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1241
Practice Address - Country:US
Practice Address - Phone:304-399-7484
Practice Address - Fax:304-399-7579
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13435207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6425700900OtherKY HEALTH CHOICES
OH000000271243OtherOH UNISON
OH0580447Medicaid
WV1025092OtherBRICKSTREET
WV613154600OtherBLACK LUNG
WV3918368OtherCIGNA
KY7100073660Medicaid
WV0084541000Medicaid
WV0084541000Medicaid
KY6425700900OtherKY HEALTH CHOICES
WV3918368OtherCIGNA
OH0580447Medicaid