Organization
ADULT HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDO GARZA IV M.D. (PHYSICIAN)
(956) 230-8242
Entity
Organization
Contact information
Practice address
1519 E BUSTAMANTE ST STE B, LAREDO, TX 78041-5305
(956) 230-8242
Mailing address
1519 E BUSTAMANTE ST STE B, LAREDO, TX 78041-5305
(956) 230-8242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
Q6414
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174883177
INDIVIDUAL NPI
TX
Enumeration date
08/30/2016
Last updated
11/10/2016
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