Provider Demographics
NPI:1891135182
Name:MEZA, EDUARDO (DDS)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:MEZA
Suffix:
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 1:4000 MANCHACA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6738
Mailing Address - Country:US
Mailing Address - Phone:512-441-2098
Mailing Address - Fax:512-441-3550
Practice Address - Street 1:4000 MANCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6738
Practice Address - Country:US
Practice Address - Phone:512-441-2098
Practice Address - Fax:512-441-3550
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX298631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice