MEDICARE: DR. JOHN LELAND COVERT 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	14036	TX

General Provider Information

NPI Number	:	1649329335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LELAND COVERT DDS

Provider Business Mailing Address
First Line	:	7701 TEZEL RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-3039
Country	:	US
Telephone Number	:	210-647-0477
Fax Number	:	210-647-3765

Provider Business Practice Location Address
First Line	:	7701 TEZEL RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-3039
Country	:	US
Telephone Number	:	210-647-0477
Fax Number	:	210-647-3765

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. JOHN LELAND COVERT DDS” Practice Location

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