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NPI Code Detail

MEDICARE: DR MINA CHA DDS PA

MEDICARE: DR MINA CHA DDS PA
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
1122300000XDentist16816TX

General Provider Information

NPI Number : 1447353933
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR MINA CHA DDS PA
Provider Business Mailing Address
First Line : 1825 BANDERA ROAD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228
Country : US
Telephone Number : 210-434-8431
Fax Number : 210-432-8130
Provider Business Practice Location Address
First Line : 1825 BANDERA ROAD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228
Country : US
Telephone Number : 210-434-8431
Fax Number : 210-432-8130
Authorized Official
Title or Position : OWNER
Name : DR. MINA CHA
Credential : DDS
Telephone Number : 210-434-8431
Provider Enumeration Date : 09/07/2006
Last Update Date : 08/22/2020

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