Provider Demographics
NPI:1952301798
Name:ENDODONTIC CONSULTANTS OF SAN ANTONIO
Entity Type:Organization
Organization Name:ENDODONTIC CONSULTANTS OF SAN ANTONIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-405-0473
Mailing Address - Street 1:1130 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4235
Mailing Address - Country:US
Mailing Address - Phone:210-405-0473
Mailing Address - Fax:210-490-7699
Practice Address - Street 1:1130 E SONTERRA BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4235
Practice Address - Country:US
Practice Address - Phone:210-405-0473
Practice Address - Fax:210-490-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty