| Atx Pedo Pllc | |
|
1217 W Slaughter Ln Ste 140 Austin TX 78748-6577 | |
| (512) 643-8900 | |
| Not Available |
| Full Name | Atx Pedo Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1217 W Slaughter Ln Ste 140, Austin, Texas |
| Authorized Official Name and Position | Sarah Theresa Delacruz (MANAGER) |
| Authorized Official Contact | 5127747833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atx Pedo Pllc 1217 W Slaughter Ln Ste 140 Austin TX 78748-6577 Ph: (512) 643-8900 | Atx Pedo Pllc 1217 W Slaughter Ln Ste 140 Austin TX 78748-6577 Ph: (512) 643-8900 |
| NPI Number | 1043873854 |
|---|---|
| Provider Enumeration Date | 04/17/2019 |
| Last Update Date | 04/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043873854 | NPI | - | NPPES |
| 286329203 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Jared Poplin D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6850 Austin Center Blvd Ste 220, Austin, TX 78731 Phone: 785-691-6171 | |
Ac Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13616 N Highway 183, Austin, TX 78750 Phone: 512-682-5437 | |