Provider Demographics
NPI:1073174835
Name:WALKER, XAVIER J (DDS)
Entity Type:Individual
Prefix:DR
First Name:XAVIER
Middle Name:J
Last Name:WALKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14200 VANCE JACKSON RD APT 11307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1960
Mailing Address - Country:US
Mailing Address - Phone:432-940-1462
Mailing Address - Fax:
Practice Address - Street 1:203 N LOOP 1604 W STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1086
Practice Address - Country:US
Practice Address - Phone:210-490-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice