MEDICARE: RHESA DEL ROSARIO BAUTISTA 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	1223G0001X	General Practice Dentistry	21431	TX

General Provider Information

NPI Number	:	1518052455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHESA DEL ROSARIO BAUTISTA DDS

Provider Business Mailing Address
First Line	:	4418 ALMEDA RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-4902
Country	:	US
Telephone Number	:	713-528-0040
Fax Number	:

Provider Business Practice Location Address
First Line	:	4418 ALMEDA RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-4902
Country	:	US
Telephone Number	:	713-528-0040
Fax Number	:

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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Directions to “ RHESA DEL ROSARIO BAUTISTA DDS” Practice Location

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