Provider Demographics
NPI:1841801586
Name:VERASTEGUI, JUAN A
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:VERASTEGUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13721 ECCLES RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-5996
Mailing Address - Country:US
Mailing Address - Phone:915-234-7344
Mailing Address - Fax:
Practice Address - Street 1:1717 BROWN ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4727
Practice Address - Country:US
Practice Address - Phone:915-544-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364901223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice