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General NPI Number Information
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NPI Number | 1770627911
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Entity Type | Individual
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Provider Name | WILLIS DAVID EGGER D.D.S
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Gender | Male
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 1609 N CONWAY AVE.
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City | MISSION
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State | TX
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Zip | 78572
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Country | US
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Telephone | 956-519-9398
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Fax | 956-519-7166
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Provider Business Mailing Address
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Address Line | 1609 N CONWAY AVE
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City | MISSION
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State | TX
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Zip | 78572-4008
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Country | US
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Telephone | 956-519-9398
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Fax | 956-519-7166
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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 | 19383
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License Number State | TX
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