Provider Demographics
NPI:1760648869
Name:DON TEST III, D.D.S., INC.
Entity Type:Organization
Organization Name:DON TEST III, D.D.S., INC.
Other - Org Name:DRS. PORTALES & TEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:TEST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-349-3161
Mailing Address - Street 1:2803 MOSSROCK
Mailing Address - Street 2:STE. 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5121
Mailing Address - Country:US
Mailing Address - Phone:210-349-3161
Mailing Address - Fax:210-349-3825
Practice Address - Street 1:2803 MOSSROCK
Practice Address - Street 2:STE. 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5121
Practice Address - Country:US
Practice Address - Phone:210-349-3161
Practice Address - Fax:210-349-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090197702Medicaid
TX090213202Medicaid
TXT15343Medicare UPIN
TX090213202Medicaid