Provider Demographics
NPI:1043322274
Name:GARZA, EDWARD (OD)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:GARZA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5488 S PADRE ISLAND DR
Mailing Address - Street 2:STE 2042
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4109
Mailing Address - Country:US
Mailing Address - Phone:361-994-0310
Mailing Address - Fax:361-994-0452
Practice Address - Street 1:5488 S PADRE ISLAND DR
Practice Address - Street 2:STE 2042
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4109
Practice Address - Country:US
Practice Address - Phone:361-994-0310
Practice Address - Fax:361-994-0452
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4471TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U48294Medicare UPIN
TX82533EMedicare ID - Type Unspecified