| Mark Garza, M.d., Pllc | |
|
7148 Trail Lake Dr Fort Worth TX 76123-1969 | |
| (817) 294-0934 | |
| (817) 294-1488 |
| Full Name | Mark Garza, M.d., Pllc |
|---|---|
| Speciality | Pain Medicine |
| Location | 7148 Trail Lake Dr, Fort Worth, Texas |
| Authorized Official Name and Position | Mark Anthony Garza (OWNER) |
| Authorized Official Contact | 8172940934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Garza, M.d., Pllc 7148 Trail Lake Dr Fort Worth TX 76123-1969 Ph: (817) 294-0934 | Mark Garza, M.d., Pllc 7148 Trail Lake Dr Fort Worth TX 76123-1969 Ph: (817) 294-0934 |
| NPI Number | 1154841963 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3072874551 |
|---|---|
| Medicare Enrollment ID | O20180223002384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154841963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | M9302 (Texas) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | M9302 (Texas) | Primary |
| Provider Name | Mark A Garza |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1548436934 PECOS PAC ID: 3678765062 Enrollment ID: I20101004000836 |
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