| Oral And Maxillofacial Surgery Of South Texas, P.a. | |
|
4728 South Jackson Rd Edinburg TX 78539 | |
| (956) 878-1222 | |
| (956) 878-1228 |
| Full Name | Oral And Maxillofacial Surgery Of South Texas, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 4728 South Jackson Rd, Edinburg, Texas |
| Authorized Official Name and Position | Francisco M Perez (OWNER) |
| Authorized Official Contact | 9568781222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral And Maxillofacial Surgery Of South Texas, P.a. 4728 S. Jackson Road Edinburg TX 78539-6199 Ph: (956) 878-1222 | Oral And Maxillofacial Surgery Of South Texas, P.a. 4728 South Jackson Rd Edinburg TX 78539 Ph: (956) 878-1222 |
| NPI Number | 1043544893 |
|---|---|
| Provider Enumeration Date | 09/28/2009 |
| Last Update Date | 07/26/2010 |
| Medicare PECOS PAC ID | 7214065523 |
|---|---|
| Medicare Enrollment ID | O20100506000855 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043544893 | NPI | - | NPPES |
| 210859903 | Other | TX | TRADITIONAL MEDICAID |
| 210859901 | Other | TX | THSTEPS DENTAL MEDICAID |
| 210859905 | Other | TX | CSHCN MEDICAL MEDICAID |
| 210859902 | Other | TX | CSHCN DENTAL MEDICAID |
| 210859904 | Other | TX | THSTEPS MEDICAL MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 20137 (Texas) | Primary |
| Provider Name | Francisco Manuel Perez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1851381214 PECOS PAC ID: 5799670360 Enrollment ID: I20100507000194 |
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