MEDICARE: DR. LAZARO EMANUEL TOBIAS 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	122300000X	Dentist	40426	TX

General Provider Information

NPI Number	:	1760180491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAZARO EMANUEL TOBIAS DDS

Provider Business Mailing Address
First Line	:	8210 FLOYD CURL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3923
Country	:	US
Telephone Number	:	210-450-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 JUNCTION HWY
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5198
Country	:	US
Telephone Number	:	210-450-3700
Fax Number	:

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

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	06/18/2024

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