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NPI Code Detail

MEDICARE: JUAN C ECHEVERN DDS PROFESSIONAL CORP

MEDICARE: JUAN C ECHEVERN DDS PROFESSIONAL CORP
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
11223G0001XGeneral Practice Dentistry16902TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790805141
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUAN C ECHEVERN DDS PROFESSIONAL CORP
Provider Business Mailing Address
First Line : 7844 LONG POINT RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-3621
Country : US
Telephone Number : 713-956-8767
Fax Number : 713-956-1952
Provider Business Practice Location Address
First Line : 7844 LONG POINT RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-3621
Country : US
Telephone Number : 713-956-8767
Fax Number : 713-956-1952
Authorized Official
Title or Position : PRESIDENT
Name : DR. JUAN C ECHEVERRI
Credential : DDS
Telephone Number : 713-956-8767
Provider Enumeration Date : 03/30/2007
Last Update Date : 06/19/2008

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