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General NPI Number Information
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NPI Number | 1295893378
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Entity Type | Individual
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Provider Name | HONEY SUE BARGATZE DDS
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | TRAILS DENTAL GROUP AND ORTHODONTICS 8300 FM 620 N BUILDING G STE 100
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City | AUSTIN
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State | TX
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Zip | 78726
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Country | US
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Telephone | 512-331-0359
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Fax |
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Provider Business Mailing Address
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Address Line | 15222 FM 620 N APT 5109
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City | AUSTIN
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State | TX
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Zip | 78717-5129
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Country | US
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Telephone | 615-364-3352
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39211
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License Number State | TX
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