Provider Demographics
NPI:1023021458
Name:POQUIZ, DENNIS E (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:E
Last Name:POQUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 W GREEN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-1222
Mailing Address - Country:US
Mailing Address - Phone:817-496-4957
Mailing Address - Fax:817-496-3783
Practice Address - Street 1:2309 W GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-1222
Practice Address - Country:US
Practice Address - Phone:817-496-4957
Practice Address - Fax:817-496-3783
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0025NYOtherBLUE CROSS BLUE SHIELD
TX0025NYOtherBLUE CROSS BLUE SHIELD
TX00969LMedicare PIN