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NPI 1073055653

NPI 1073055653 : CAIO RANDI FERRAZ DDS, MS, PHD : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1073055653
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    Entity Type          |    Individual 
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    Provider Name        |    CAIO RANDI FERRAZ DDS, MS, PHD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/14/2016
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    Last Update Date     |    11/16/2016
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Provider Practice Location Address
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    Address Line         |    8210 FLOYD CURL DR 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78229-3923
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    Country              |    US
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    Telephone            |    210-450-3636
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8718 POPPY HLS 
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    City                 |    BOERNE
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    State                |    TX
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    Zip                  |    78015-4883
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    Country              |    US
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    Telephone            |    210-450-3636
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223E0200X
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    Taxonomy Name        |    Endodontics
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    License Number       |    31880
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    License Number State |    TX
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