Provider Demographics
NPI:1447374350
Name:GARZA, MANUEL J (LBSW)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:J
Last Name:GARZA
Suffix:
Gender:M
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 W POLK ST
Mailing Address - Street 2:SUITE 13
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-2136
Mailing Address - Country:US
Mailing Address - Phone:956-781-4700
Mailing Address - Fax:
Practice Address - Street 1:1313 W POLK ST
Practice Address - Street 2:SUITE 13
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2136
Practice Address - Country:US
Practice Address - Phone:956-781-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25857171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator