| E. Thomas Bice, Jr., D.d.s., P.a. | |
|
4496 Callaghan Rd San Antonio TX 78228-3400 | |
| (210) 435-4601 | |
| (210) 435-7131 |
| Full Name | E. Thomas Bice, Jr., D.d.s., P.a. |
|---|---|
| Speciality | Dentist |
| Location | 4496 Callaghan Rd, San Antonio, Texas |
| Authorized Official Name and Position | Ernest Thomas Bice (DENTIST/OWNER) |
| Authorized Official Contact | 2104354601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E. Thomas Bice, Jr., D.d.s., P.a. 4496 Callaghan Rd San Antonio TX 78228-3400 Ph: (210) 435-4601 | E. Thomas Bice, Jr., D.d.s., P.a. 4496 Callaghan Rd San Antonio TX 78228-3400 Ph: (210) 435-4601 |
| NPI Number | 1831366400 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831366400 | NPI | - | NPPES |
| 00704262 | Other | TX | UNITED CONCORDIA |
| 00191100 | Other | TX | UNITED CONCORDIA |
| G-60093 | Other | TX | TEXAS CHIP |
| D17059 | Other | TX | BC/BS |
| 00M240 | Other | TX | BC/BS |
| B09277 | Other | TX | TEXAS CHIP |
| 007987301 | Medicaid | TX | |
| 090184502 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 17059 (Texas) | Primary |
| 122300000X | Dentist | 9277 (Texas) | Secondary |
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