Provider Demographics
NPI:1588868236
Name:R GARZA, O.D., P.A.
Entity type:Organization
Organization Name:R GARZA, O.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-980-3937
Mailing Address - Street 1:5425 S PADRE ISLAND DR STE 135A
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5330
Mailing Address - Country:US
Mailing Address - Phone:361-980-3937
Mailing Address - Fax:361-980-0394
Practice Address - Street 1:5425 S PADRE ISLAND DR STE 135A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5330
Practice Address - Country:US
Practice Address - Phone:361-980-3937
Practice Address - Fax:361-980-0394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5244TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00389UMedicare PIN