Provider Demographics
NPI:1962816355
Name:LOERA, RENE JAVIER JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:JAVIER
Last Name:LOERA
Suffix:JR
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 1:3133 N TOWN EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3920
Mailing Address - Country:US
Mailing Address - Phone:972-270-2911
Mailing Address - Fax:972-270-0798
Practice Address - Street 1:3133 N TOWN EAST BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:972-270-2911
Practice Address - Fax:972-270-0798
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice