Provider Demographics
NPI:1033575519
Name:ENRIQUE DARANCOU PLLC
Entity Type:Organization
Organization Name:ENRIQUE DARANCOU PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARANCOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-530-8567
Mailing Address - Street 1:210 THUNDERBIRD DR STE X
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3910
Mailing Address - Country:US
Mailing Address - Phone:319-530-8567
Mailing Address - Fax:
Practice Address - Street 1:210 THUNDERBIRD DR STE X
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3910
Practice Address - Country:US
Practice Address - Phone:319-530-8567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty