Individual provider Active NPI

Roel Garza, D.D.S.

  • General Practice Dentistry
  • Alice, TX
National Provider Identifier
1447453626
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17020 Issued in TX
Practice address
750 Coyote TRL
Alice, TX 78332-4004
Phone
(361) 668-3384
Fax
(361) 668-6191
NPI assigned
Jun 6, 2007
Last updated
Jun 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17020 TX Primary

Addresses

Primary practice location

750 Coyote TRL
Alice, TX 78332-4004

Mailing address

750 Coyote Trail
Alice, TX 78332
Phone (361) 668-3384

Other identifiers 3

IdentifierTypeStateIssuer
87D471OtherTXBCBS
11241902MedicaidTX
UC886411OtherTXUNITED CONCORDIA

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

LicenseStateTypeSpecialty
17020TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Garza, Garcia & Garcia Dentistry Partnership General Practice Past Accepting new patients
Dr. Roel Garza and Associates Family Dentistry General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1447453626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 COYOTE TRAIL",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "78332",
            "telephone_number": "361-668-3384",
            "fax_number": "361-668-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 COYOTE TRL",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783324004",
            "telephone_number": "361-668-3384",
            "fax_number": "361-668-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "ROEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87D471",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11241902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "UC886411",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alice, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.