Provider Demographics
NPI:1447540638
Name:GARZA, RODOLFO O (DDS MD)
Entity type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:O
Last Name:GARZA
Suffix:
Gender:M
Credentials:DDS MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14119 GRANT RD STE 140
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1396
Mailing Address - Country:US
Mailing Address - Phone:832-930-7801
Mailing Address - Fax:832-559-1066
Practice Address - Street 1:14119 GRANT RD STE 140
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1396
Practice Address - Country:US
Practice Address - Phone:832-930-7801
Practice Address - Fax:832-559-1066
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-09
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270841223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty