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General NPI Number Information
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NPI Number | 1700942653
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Entity Type | Organization
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Legal Business Name | LINDALE MEDICAL DENTAL GROUP
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 500 PAREDES LINE RD #3
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2583
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Country | US
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Telephone | 956-541-2162
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Fax | 956-541-8043
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Provider Business Mailing Address
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Address Line | 500 PAREDES LINE RD #3
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2583
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Country | US
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Telephone | 956-541-2162
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Fax | 956-541-8043
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. ERNESTO S DAVILA
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Credential | DDS
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Telephone | 956-541-2162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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