Provider Demographics
NPI:1548992639
Name:GARZA, JOEL JR
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:GARZA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2768 PHARMACY RD
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6201
Mailing Address - Country:US
Mailing Address - Phone:956-487-5621
Mailing Address - Fax:
Practice Address - Street 1:2768 PHARMACY RD
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6201
Practice Address - Country:US
Practice Address - Phone:956-487-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16558363A00000X
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant