Active NPI
Gustavo Ali Garza, DDS
- Dentist
- Mission, TX
National Provider Identifier
1417566803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36398
- Practice address
- 600 E Griffin Pkwy Ste a
Mission, TX 78572-2980 - Phone
- (956) 583-9600
- NPI assigned
- Jul 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36398 | TX | Primary |
Addresses
Primary practice location
600 E Griffin Pkwy Ste a
Mission, TX 78572-2980
Mailing address
500 N Bryan Rd Unit A18
Mission, TX 78572-8880
Phone (956) 638-0152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36398 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596153600000",
"number": "1417566803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N BRYAN RD UNIT A18",
"city": "MISSION",
"state": "TX",
"postal_code": "785728880",
"telephone_number": "956-638-0152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E GRIFFIN PKWY STE A",
"city": "MISSION",
"state": "TX",
"postal_code": "785722980",
"telephone_number": "956-583-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARZA",
"first_name": "GUSTAVO",
"middle_name": "ALI",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-30",
"last_updated": "2020-07-31",
"certification_date": "2020-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "36398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.