Provider Demographics
NPI:1376927350
Name:SHOVAK, KAREN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:G
Last Name:SHOVAK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 W SAM HOUSTON BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5224
Mailing Address - Country:US
Mailing Address - Phone:956-782-6767
Mailing Address - Fax:
Practice Address - Street 1:1002 W SAM HOUSTON BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5224
Practice Address - Country:US
Practice Address - Phone:956-782-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-19
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX312041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice