Basic Information
| Provider Information | |||||||||
| NPI: | 1760927149 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARZA | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6002 MAVERICK RD | ||||||||
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| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785216323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562041020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 95 E PRICE RD BLDG F | ||||||||
| Address2: | |||||||||
| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785213531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9565046080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2016 | ||||||||
| LastUpdateDate: | 12/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | AP132814 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.