MEDICARE: TX SOUTHERN DENTAL PPO PC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1558131938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TX SOUTHERN DENTAL PPO PC

Provider Business Mailing Address
First Line	:	5830 GRANITE PKWY STE 780
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6775
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7189 WESTWIND DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-1748
Country	:	US
Telephone Number	:	915-584-0400
Fax Number	:

Authorized Official
Title or Position	:	VP, REVENUE CYCLE
Name	:	CHRISTINE NELSON
Credential	:
Telephone Number	:	469-450-6482

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	01/05/2024

Similar Medicare Providers

1760575724 — JIM BOWDEN DDS PA
Practice Location Address:

7185 WESTWIND DR
EL PASO, TX
79912-1748

Practice Phone: 915-585-6373
Practice Fax: 915-585-6372

1699938266 — JIM BOWDEN D.D.S.
Practice Location Address:

7185 WESTWIND DR
EL PASO, TX
79912-1748

Practice Phone: 915-585-6373
Practice Fax:

1881254019 — DARYL MARIE STEIN AGUILAR DDS
Practice Location Address:

7189 WESTWIND DR
EL PASO, TX
79912-1748

Practice Phone: 915-584-0400
Practice Fax:

1275716425 — FIRST MOUNTAIN STAR INJURY CLINIC
Practice Location Address:

5630 GATEWAY BLVD E , STE. 5-E
EL PASO, TX
79905-1748

Practice Phone: 915-781-7827
Practice Fax: 915-781-0884

1750522413 — ARTURO J BEJARANO JR DDS PC
Practice Location Address:

5630 GATEWAY BLVD E STE 4
EL PASO, TX
79905-1748

Practice Phone: 915-772-5200
Practice Fax: 915-772-8907

1356861470 — NUCH OF TEXAS
Practice Location Address:

10765 KENWORTHY ST STE A
EL PASO, TX
79924-1748

Practice Phone: 915-320-4021
Practice Fax: 915-320-4031

Directions to “TX SOUTHERN DENTAL PPO PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.