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General NPI Number Information
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NPI Number | 1659237063
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Entity Type | Individual
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Provider Name | LIDIA CRISTINA JASSO DDS
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Gender | Female
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | AQUILES SERDAN 3429
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City | NUEVO LAREDO
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State | TAMAULIPAS
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Zip | 88270
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Country | MX
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 7902 E COUNTRY DR APT 1318
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City | LAREDO
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State | TX
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Zip | 78045-9029
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Country | US
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Telephone | 956-754-6970
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 14056938
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License Number State | TX
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