Healthcare Provider Details

I. General information

NPI: 1609977578
Provider Name (Legal Business Name): OSWALDO HEGUIGORRI D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 E PRICE RD
BROWNSVILLE TX
78521-3527
US

IV. Provider business mailing address

191 E PRICE RD
BROWNSVILLE TX
78521-3527
US

V. Phone/Fax

Practice location:
  • Phone: 956-548-7400
  • Fax: 956-621-3689
Mailing address:
  • Phone: 956-548-7400
  • Fax: 956-621-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number16425
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16425
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: