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General NPI Number Information
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NPI Number | 1386132884
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Entity Type | Individual
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Provider Name | JOSUE VEGA DDS
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Gender | Male
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 1202 W BITTERS RD BLDG 6
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City | SAN ANTONIO
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State | TX
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Zip | 78216-7852
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Country | US
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Telephone | 210-491-0015
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Fax |
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Provider Business Mailing Address
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Address Line | 1202 W BITTERS RD BLDG 6
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City | SAN ANTONIO
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State | TX
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Zip | 78216-7852
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Country | US
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Telephone | 210-491-0015
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 34309
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN26744
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License Number State | FL
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