| South Texas Periodontal Associates | |
|
6502 Bandera Rd Ste 102 San Antonio TX 78238-1445 | |
| (210) 680-0706 | |
| (210) 509-4518 |
| Full Name | South Texas Periodontal Associates |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 6502 Bandera Rd Ste 102, San Antonio, Texas |
| Authorized Official Name and Position | Brian Wallace Beck (OWNER) |
| Authorized Official Contact | 2106547878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Texas Periodontal Associates 6502 Bandera Rd Ste 102 San Antonio TX 78238-1445 Ph: (210) 680-0706 | South Texas Periodontal Associates 6502 Bandera Rd Ste 102 San Antonio TX 78238-1445 Ph: (210) 680-0706 |
| NPI Number | 1659698215 |
|---|---|
| Provider Enumeration Date | 04/22/2010 |
| Last Update Date | 04/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659698215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 15287 (Texas) | Primary |
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