MEDICARE: DR. NEKER ESTEBAN BERNUY DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	28643	TX

General Provider Information

NPI Number	:	1184064107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEKER ESTEBAN BERNUY DDS

Provider Business Mailing Address
First Line	:	1720 GRAND AVENUE PKWY APT 4208
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2080
Country	:	US
Telephone Number	:	646-753-2164
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 AUSTIN HWY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-4455
Country	:	US
Telephone Number	:	714-450-0346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	07/09/2013

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