Provider Demographics
NPI:1174228605
Name:GARZA, YESSICA YESSENIA
Entity type:Individual
Prefix:
First Name:YESSICA
Middle Name:YESSENIA
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NONESUCH RD APT 1505
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1520
Mailing Address - Country:US
Mailing Address - Phone:325-933-7962
Mailing Address - Fax:
Practice Address - Street 1:2601 NONESUCH RD APT 1505
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-1520
Practice Address - Country:US
Practice Address - Phone:325-933-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician