Healthcare Provider Details

I. General information

NPI: 1629785548
Provider Name (Legal Business Name): PAZ DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4336 N MCCOLL RD
MCALLEN TX
78504-2477
US

IV. Provider business mailing address

6868 SAN PEDRO AVE
SAN ANTONIO TX
78216-7201
US

V. Phone/Fax

Practice location:
  • Phone: 956-414-3575
  • Fax: 956-468-3303
Mailing address:
  • Phone: 210-504-7000
  • Fax: 888-840-0064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFF PAZ
Title or Position: OWNER
Credential: DDS
Phone: 210-504-7000