Healthcare Provider Details

I. General information

NPI: 1770828832
Provider Name (Legal Business Name): T. JOHN PARSI DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 HUEBNER RD SUITE 265
SAN ANTONIO TX
78240-1558
US

IV. Provider business mailing address

9150 HUEBNER RD SUITE 265
SAN ANTONIO TX
78240-1558
US

V. Phone/Fax

Practice location:
  • Phone: 210-561-1530
  • Fax: 210-561-0552
Mailing address:
  • Phone: 210-561-1530
  • Fax: 210-561-0552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19471
License Number StateTX

VIII. Authorized Official

Name: T. JOHN PARSI
Title or Position: DENTIST
Credential: DDS
Phone: 210-561-1530