=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235428392
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DANIEL SAENZ, D.D.S., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2011
-----------------------------------------------------
Last Update Date | 04/14/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2515 PLEASANTON RD
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78221-1506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-922-5401
-----------------------------------------------------
Fax | 210-923-2441
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2515 PLEASANTON RD
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78221-1506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-922-5401
-----------------------------------------------------
Fax | 210-923-2441
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE PROPRIETOR
-----------------------------------------------------
Name | DR. DANIEL D SAENZ
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 210-922-5401
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 13566
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------