Basic Information
Provider Information
NPI: 1770875346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARZA
FirstName: METARI
MiddleName: S.
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146450624
FaxNumber: 2146450078
Practice Location
Address1: 6363 FOREST PARK RD 7TH FLOOR STE 749
Address2:  
City: DALLAS
State: TX
PostalCode: 753906440
CountryCode: US
TelephoneNumber: 2146458500
FaxNumber: 2146453775
Other Information
ProviderEnumerationDate: 05/13/2011
LastUpdateDate: 12/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X40835TXY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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