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13791 Horizon Blvd. Ste. B4 Horizon City TX 79928 | |
| (915) 755-7900 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 13791 Horizon Blvd. Ste. B4, Horizon City, Texas |
| Authorized Official Name and Position | Luz Fernandez (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 9152747071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3201 Cherry Ridge St Ste A101 San Antonio TX 78230-4824 Ph: () - | 13791 Horizon Blvd. Ste. B4 Horizon City TX 79928 Ph: (915) 755-7900 |
| NPI Number | 1932766409 |
|---|---|
| Provider Enumeration Date | 05/21/2019 |
| Last Update Date | 12/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932766409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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