Provider Demographics
NPI:1952590580
Name:OMAR D GARZA, OD, PA
Entity Type:Organization
Organization Name:OMAR D GARZA, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:D
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-846-3252
Mailing Address - Street 1:PO BOX 23007
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-0007
Mailing Address - Country:US
Mailing Address - Phone:210-533-0101
Mailing Address - Fax:210-533-9292
Practice Address - Street 1:1343 FAIR AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1437
Practice Address - Country:US
Practice Address - Phone:210-533-0101
Practice Address - Fax:210-533-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5979T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8C0682Medicare UPIN
00996WMedicare PIN