Individual provider Active NPI

Marcel Andre Garza, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1699979567
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03115 Issued in TX
Practice address
1010 W 40TH St
Austin, TX 78756-4010
Phone
(512) 459-8753
Fax
(512) 483-6807
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03115 TX Primary

Addresses

Primary practice location

1010 W 40TH St
Austin, TX 78756-4010

Mailing address

1010 W 40TH St
Austin, TX 78756-4010
Phone (512) 459-8753

Other identifiers 2

IdentifierTypeStateIssuer
PA03115OtherTXMEDICAL LICENSE
8Y1982OtherTXBCBS ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610001054 TX Practitioner - Physician Assistant 9931182938 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Davids Carenow Urgent Care PLLCGroup PAC ID 4284918418, 101 clinicians

Practice addresses (Care Compare)

135 Bunton Creek Rd
Suite 100
Kyle, TX 78640-5701
Phone (512) 268-2068

5033 W Hwy 290
Carenow
Austin, TX 78735-6751
Phone (512) 265-8980

517 S Lamar Blvd
Suite B
Austin, TX 78704-1549
Phone (512) 861-8055

717 Hwy 71 W
Suite 500
Bastrop, TX 78602-4148
Phone (521) 332-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03115TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Oct 4, 2016 Accepting new patients
Citimed, P.a. Past Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1699979567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 40TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564010",
            "telephone_number": "512-459-8753",
            "fax_number": "512-483-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W 40TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564010",
            "telephone_number": "512-459-8753",
            "fax_number": "512-483-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "MARCEL",
        "middle_name": "ANDRE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA03115",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "8Y1982",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.