South Park Family Dental Care Pa
LBN: South Park Family Dental Care Pa
South Park Family Dental Care Pa is an health care organization with primary practice located at 2310 Sw Military Dr Ste 406, San Antonio TX 78224-1407. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty.
South Park Family Dental Care Pa can be contacted via phone (210) 927-1400, or through Izaddoust, Shiva via phone (210) 927-1400.
Contact Information
Primary practice address
2310 Sw Military Dr Ste 406
San Antonio TX 78224-1407
Phone: (210) 927-1400
Fax: (210) 927-6330
Website:
Authorized official contact:
Name: Izaddoust, Shiva Doctor of Dental Surgery (DDS)
Phone: (210) 927-1400
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Dental | 261QD0000X |
Profile Details
| NPI number | 1467586768 |
|---|---|
| LBN Legal business name | South Park Family Dental Care Pa |
| DBA Doing business as | |
| Authorized official | Izaddoust, Shiva Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 16th, 2007 |
| Last updated | May 24th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467586768 | NPPES |
| Texas | Other | G60126-3 | TEXAS CHIP |
| Texas | Other | 0064GJ | TEXAS CHIP |
| Texas | Other | 1300537 | TEXAS CHIP |
| Texas | MEDICAID | 0099152-01 | TEXAS CHIP |
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