Basic Information
| Provider Information | |||||||||
| NPI: | 1174642698 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JUAN JOEL GARZA, MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 E. RIDGE ROAD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566305522 | ||||||||
| FaxNumber: | 9569264350 | ||||||||
| Practice Location | |||||||||
| Address1: | 2310 N. ED CAREY DRIVE | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564285522 | ||||||||
| FaxNumber: | 9569264350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 02/04/2009 | ||||||||
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| AuthorizedOfficialLastName: | HERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | NORMALINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIAL COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9564303413 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | K7157 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | P00311777 | 01 | TX | MEDICARE RR | OTHER |