Elizondo, Eutiquio M
Elizondo, Eutiquio M is an sole proprietor health care provider with primary practice located at 100 E Ebony Lane , Edinburg TX 78539. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Elizondo, Eutiquio M can be contacted via phone (956) 380-3636.Contact Information
Primary practice address
100 E Ebony Lane
Edinburg TX 78539
Phone: (956) 380-3636
Fax: (956) 316-3866
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 742912615 | Texas |
Profile Details
| NPI number | 1396825949 |
|---|---|
| LBN Legal business name | Elizondo, Eutiquio M |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Apr 5th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396825949 | NPPES |
| Texas | MEDICAID | 111245001 | |
| Texas | Other | B14495 |
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