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General NPI Number Information
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NPI Number | 1851915029
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Entity Type | Individual
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Provider Name | DAVID COLMENAR
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Gender | Male
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 2600 FM 1764 RD STE 170
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City | LA MARQUE
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State | TX
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Zip | 77568-2828
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Country | US
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Telephone | 409-240-2484
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Fax |
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Provider Business Mailing Address
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Address Line | 660 W BEVERLY DR
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City | OXNARD
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State | CA
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Zip | 93030-4616
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Country | US
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Telephone | 805-512-6859
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36153
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 36153
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License Number State | TX
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