MEDICARE: ELISABETH IRENE ROWOLD-GARCIAMENDEZ D.D.S., M.S.

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	1223P0221X	Pediatric Dentistry	18425	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000ZBX696	OTHER	MA	BCBS OF MA ID#
2	900-53478	OTHER	AL	BCBS OF ALABAMA ID#
3	75288660401011	OTHER	UT	BCBS OF UTAH ID#
4	861423	OTHER	TX	UNITED CONCORDIA ID #
5	85D713	OTHER	TX	BCBS OF TEXAS PROVIDER #

General Provider Information

NPI Number	:	1972632123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH IRENE ROWOLD-GARCIAMENDEZ D.D.S., M.S.

Provider Business Mailing Address
First Line	:	335 N ALLEN DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-2539
Country	:	US
Telephone Number	:	972-727-0011
Fax Number	:	972-727-0707

Provider Business Practice Location Address
First Line	:	335 N ALLEN DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-2539
Country	:	US
Telephone Number	:	972-727-0011
Fax Number	:	972-727-0707

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	06/22/2026

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