Healthcare Provider Details

I. General information

NPI: 1972768307
Provider Name (Legal Business Name): LILIANA MEEKER, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E SONTERRA BLVD SUITE 100
SAN ANTONIO TX
78258-4053
US

IV. Provider business mailing address

335 E SONTERRA BLVD SUITE 100
SAN ANTONIO TX
78258-4053
US

V. Phone/Fax

Practice location:
  • Phone: 210-494-8022
  • Fax: 210-494-8023
Mailing address:
  • Phone: 210-494-8022
  • Fax: 210-494-8023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number22936
License Number StateTX

VIII. Authorized Official

Name: DR. LILIANA M MEEKER
Title or Position: ENDODONTIST
Credential: DDS
Phone: 210-494-8022