| Riata Dental | |
|
12545 Riata Vista Circle Ms 578-awc Austin TX 78727 | |
| (512) 526-5126 | |
| (512) 583-0699 |
| Full Name | Riata Dental |
|---|---|
| Speciality | Dentist |
| Location | 12545 Riata Vista Circle Ms 578-awc, Austin, Texas |
| Authorized Official Name and Position | Elizabeth Lowery (PRESIDENT) |
| Authorized Official Contact | 5126581553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riata Dental 12545 Riata Vista Circle Ms 578-awc Austin TX 78727 Ph: (512) 526-5126 | Riata Dental 12545 Riata Vista Circle Ms 578-awc Austin TX 78727 Ph: (512) 526-5126 |
| NPI Number | 1114068996 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114068996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21373 (Texas) | Primary |
| 122300000X | Dentist | 19588 (Texas) | Secondary |
| 122300000X | Dentist | 20624 (Texas) | Secondary |
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