Provider Demographics
NPI:1427018860
Name:DE LA GARZA, DAVID JR (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DE LA GARZA
Suffix:JR
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 1:7434 LOUIS PASTEUR
Mailing Address - Street 2:SUITE 236
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4538
Mailing Address - Country:US
Mailing Address - Phone:210-681-1113
Mailing Address - Fax:210-614-2903
Practice Address - Street 1:7434 LOUIS PASTEUR
Practice Address - Street 2:SUITE 236
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4538
Practice Address - Country:US
Practice Address - Phone:210-681-1113
Practice Address - Fax:210-614-2903
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX839341OtherUNITED CONCORDIA PROV. ID