Skip Navigation

Provider Information for 1568638682

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1568638682

Calendar   Last Updated:  2011-04-17
  Certification Date: 


Name Value
NPI 1568638682
Enumeration Date 2008-05-08
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1218 SW MILITARY DR
SAN ANTONIO, TX 78221-1535
United States

Phone: 210-928-2814 | Fax:
View Map External Link
Primary Practice Address 117 LOUIS HENNA BLVD # B230
ROUND ROCK, TX 78664-7343
United States

Phone: 512-238-7449 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist TX 26307