Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 22818 | TX |
N | 213EG0000X | General Practice | 22818 | TX |
Y | 1223P0221X | Pediatric Dentist | 22818 | TX |
NPI | 1003950858 |
---|---|
Provider Name | Dr. Krystle Garza-Peisen |
First Address | Edinburg, TX 78539 |
Second Address | Edinburg, TX 78539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 02/11/2011 |