Healthcare Provider Details

I. General information

NPI: 1750743696
Provider Name (Legal Business Name): NATALYA BEJAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2016
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12415 BANDERA 110
HELOTES TX
78023
US

IV. Provider business mailing address

12415 BANDERA 110
HELOTES TX
78023
US

V. Phone/Fax

Practice location:
  • Phone: 210-372-9454
  • Fax:
Mailing address:
  • Phone: 210-372-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number23944
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: