Provider Demographics
NPI:1497866966
Name:FEIKE, LUPITA LARA (DDS)
Entity Type:Individual
Prefix:
First Name:LUPITA
Middle Name:LARA
Last Name:FEIKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LUPITA
Other - Middle Name:L
Other - Last Name:RODRIGUEZ-FEIKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2020 PLEASANTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1305
Mailing Address - Country:US
Mailing Address - Phone:210-922-2765
Mailing Address - Fax:210-922-3813
Practice Address - Street 1:2020 PLEASANTON RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1305
Practice Address - Country:US
Practice Address - Phone:210-922-2765
Practice Address - Fax:210-922-3813
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist