Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | E6365 | TX |
N | 207PE0004X | Emergency Medical Services | E6365 | TX |
Y | 207Q00000X | Family Doctor | E6365 | TX |
N | 207VG0400X | Gynecologist | E6365 | TX |
N | 207VX0000X | Obstetrician | E6365 | TX |
N | 208000000X | Pediatrician | E6365 | TX |
NPI | 1013900497 |
---|---|
Provider Name | Pablo Garza |
First Address | Victoria, TX 77902-2644 |
Second Address | Victoria, TX 77901-3905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 12/07/2007 |