Provider Demographics
NPI:1053699637
Name:GARZA, ALEXIS N (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:N
Last Name:GARZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:N
Other - Last Name:BENCZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4212
Mailing Address - Country:US
Mailing Address - Phone:970-240-7249
Mailing Address - Fax:970-252-2619
Practice Address - Street 1:800 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4212
Practice Address - Country:US
Practice Address - Phone:970-240-7249
Practice Address - Fax:970-252-2619
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0054320207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09636757Medicaid