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General NPI Number Information
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NPI Number | 1669155214
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Entity Type | Organization
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Legal Business Name | CULEBRA FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 14124 CULEBRA RD SUITE 113
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City | SAN ANTONIO
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State | TX
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Zip | 78254
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Country | US
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Telephone | 210-787-3301
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Fax | 210-787-3304
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Provider Business Mailing Address
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Address Line | 19434 GRAN ROBLE
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3332
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Country | US
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Telephone | 213-440-2132
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Fax |
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Authorized Official
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Title or Position | OWNER/ DENTIST
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Name | ESHA S SHAH
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Credential | DDS
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Telephone | 210-787-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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