Provider Demographics
NPI:1467275172
Name:COUPLED OCCLUSION, PLLC
Entity type:Organization
Organization Name:COUPLED OCCLUSION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:TIJERINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-225-6446
Mailing Address - Street 1:4121 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4141
Mailing Address - Country:US
Mailing Address - Phone:956-225-6446
Mailing Address - Fax:
Practice Address - Street 1:1508 S LONE STAR WAY STE 3
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3603
Practice Address - Country:US
Practice Address - Phone:956-687-6103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental