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General NPI Number Information
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NPI Number | 1114311875
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Entity Type | Organization
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Legal Business Name | WESLACO FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 1214 DIXIELAND RD SUITE # 4
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City | HARLINGEN
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State | TX
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Zip | 78552-3351
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Country | US
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Telephone | 956-428-5322
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Fax | 956-428-7986
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Provider Business Mailing Address
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Address Line | 2307 W. EXP. SUITE C
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone | 956-428-5322
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Fax | 956-428-7986
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MARISOL ALANIS
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Credential |
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Telephone | 956-428-5322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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