MEDICARE: ANDREA LACERDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	41037	TX

General Provider Information

NPI Number	:	1073248969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LACERDA

Provider Business Mailing Address
First Line	:	2911 ZURICH
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2883
Country	:	US
Telephone Number	:	860-416-7497
Fax Number	:

Provider Business Practice Location Address
First Line	:	20711 WILDERNESS OAK STE 103
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-2641
Country	:	US
Telephone Number	:	210-787-1200
Fax Number	:	210-497-6077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2022
Last Update Date	:	12/11/2024

Similar Medicare Providers

1053161380 — DR. SUHEILY SANTIAGO
Practice Location Address:

20711 WILDERNESS OAK STE 107
SAN ANTONIO, TX
78258-2641

Practice Phone: 956-954-8895
Practice Fax:

1346197399 — CHRISTA KELLEY BCCS
Practice Location Address:

20711 WILDERNESS OAK STE 107
SAN ANTONIO, TX
78258-2641

Practice Phone: 210-540-0924
Practice Fax:

1922391861 — DR. MARIELENA TORRES-RICART DDS
Practice Location Address:

20711 WILDERNESS OAK STE 103
SAN ANTONIO, TX
78258-2641

Practice Phone: 210-787-1200
Practice Fax: 210-497-6077

1245064740 — ZEENIA MOMIN
Practice Location Address:

20711 WILDERNESS OAK STE 107
SAN ANTONIO, TX
78258-2641

Practice Phone: 210-995-6128
Practice Fax:

1558340976 — DR. BADR FADEL BARSOUM DENTIST
Practice Location Address:

2326 HUNTINGTON DR
SAN MARINO, CA
91108-2641

Practice Phone: 626-287-8103
Practice Fax: 626-285-2646

1093753204 — VAN NUYS DIAGNOSTIC SERVICES, INC.
Practice Location Address:

2300 HUNTINGTON DR , #B
SAN MARINO, CA
91108-2641

Practice Phone: 626-237-0502
Practice Fax: 626-237-0503

Directions to “ ANDREA LACERDA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.