Provider Demographics
NPI:1730237496
Name:GARZA, MARTHA M (MDPA)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:M
Last Name:GARZA
Suffix:
Gender:F
Credentials:MDPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4499 MEDICAL DR STE 151
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3714
Mailing Address - Country:US
Mailing Address - Phone:210-614-3352
Mailing Address - Fax:210-614-0945
Practice Address - Street 1:4499 MEDICAL DR STE 151
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3714
Practice Address - Country:US
Practice Address - Phone:210-614-3352
Practice Address - Fax:210-614-0945
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3384207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098243102Medicaid
TX00F23DMedicare PIN
TXD05725Medicare UPIN