Provider Demographics
NPI:1861120131
Name:GARZA, GISSELL (PA-C)
Entity type:Individual
Prefix:
First Name:GISSELL
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 S AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6651
Mailing Address - Country:US
Mailing Address - Phone:956-968-0596
Mailing Address - Fax:956-969-0014
Practice Address - Street 1:909 S AIRPORT DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6651
Practice Address - Country:US
Practice Address - Phone:956-968-0596
Practice Address - Fax:956-969-0014
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXPA18692363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program