Randolf Garza Jr.
Individual provider Active NPI Pediatric Nurse Practitioner · Odem, TX
NPI 1003767740 · NPPES record last updated Jun 30, 2026
Key facts
- NPI
- 1003767740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 342006 (AZ)
- Practice address
- 5035 County Road 1883
Odem, TX 78370-4064 - Phone
- (361) 813-3779
- NPI assigned
- Feb 9, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2108 E Thomas Rd
Suite 130
Phoenix, AZ 85016-0008
2108 E Thomas Rd
Suite 130
Phoenix, AZ 85016-7761
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 982120 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | 982120 | TX | |
| Pediatric Nurse Practitioner | 363LP0200X | 342006 | AZ | Yes |
Addresses
Primary practice location
5035 County Road 1883
Odem, TX 78370-4064
Mailing address
5035 County Road 1883
Odem, TX 78370-4064
Phone (361) 813-3779
Other practice location 1
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0920
Other providers in Odem, TX
- Erika Marie Aguilar
- Valerie Ann Cortez
- Sabrina Ann Gonzales
- Jennifer Lynn Hall
- Martinez Diabetic Footwear
- Doris S Martinez
- Odem-Edroy Isd
All providers in Odem, TX · Pediatric Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.