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General NPI Number Information
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NPI Number | 1245379189
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Entity Type | Organization
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Legal Business Name | ADA C YRIZARRY DMD
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 W ASHBY PL
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5839
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Country | US
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Telephone | 210-733-5899
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Fax |
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Provider Business Mailing Address
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Address Line | 115 W ASHBY PL
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5839
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Country | US
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Telephone | 210-733-5899
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. ADA C YRAZARRY
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Credential | DMD
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Telephone | 210-733-5899
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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 | 13711
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License Number State | TX
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