Saigusa, Makoto
Saigusa, Makoto is an individual health care provider with primary practice located at 805 Turtle Creek Dr , Tyler TX 75701-1937. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Saigusa, Makoto can be contacted via phone (903) 592-1664.Contact Information
Primary practice address
805 Turtle Creek Dr
Tyler TX 75701-1937
Phone: (903) 592-1664
Fax: (903) 592-6595
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | K0551 | Texas |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 19097 | Texas |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 19097 | Texas |
Profile Details
| NPI number | 1417067497 |
|---|---|
| LBN Legal business name | Saigusa, Makoto |
| Credentials | D.M.D, M.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Feb 23rd, 2023 - about last year |
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 | 1417067497 | NPPES |
| Texas | MEDICAID | 090187801 | |
| Texas | MEDICAID | 090187803 | |
| Texas | Other | 133237107 | |
| Texas | MEDICAID | 090187802 | |
| Texas | MEDICAID | 090187804 |
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