Provider Demographics
NPI:1215073093
Name:GARZA, LYDIA (SLP)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5432 PEPPERMILL RUN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4314
Mailing Address - Country:US
Mailing Address - Phone:956-574-0855
Mailing Address - Fax:956-546-8704
Practice Address - Street 1:795 PAREDES LINE RD
Practice Address - Street 2:SUITE B
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3095
Practice Address - Country:US
Practice Address - Phone:956-546-8700
Practice Address - Fax:956-546-8704
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18651OtherLICENSE