MEDICARE: JURICH BROTHERS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1013739143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JURICH BROTHERS PLLC

Provider Business Mailing Address
First Line	:	1804 BUENA VISTA ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-3805
Country	:	US
Telephone Number	:	210-227-9921
Fax Number	:	210-223-4081

Provider Business Practice Location Address
First Line	:	1804 BUENA VISTA ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-3805
Country	:	US
Telephone Number	:	210-227-9921
Fax Number	:	210-223-4081

Authorized Official
Title or Position	:	FRONT OFFICE
Name	:	MELANIE RODRIGUEZ
Credential	:
Telephone Number	:	210-227-9921

Provider Enumeration Date	:	10/29/2024
Last Update Date	:	10/29/2024

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Directions to “JURICH BROTHERS PLLC ” Practice Location

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