Healthcare Provider Details

I. General information

NPI: 1609100999
Provider Name (Legal Business Name): DAVID A PAZ SR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2009
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DENTAL CARE CENTER RIO HONDO 590 COLONIA DEL PRADO
REYNOSA TAMAULIPAS
88560
MX

IV. Provider business mailing address

702 SHERRYL AVE
PHARR TX
78577-8218
US

V. Phone/Fax

Practice location:
  • Phone: 956-451-6343
  • Fax: 866-615-5013
Mailing address:
  • Phone: 956-451-6343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2747951
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: