Provider Demographics
NPI:1669547964
Name:STROIA, AUXILLIAN LUCIANO (DDS)
Entity type:Individual
Prefix:DR
First Name:AUXILLIAN
Middle Name:LUCIANO
Last Name:STROIA
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 1:1622 N ED CAREY DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8286
Mailing Address - Country:US
Mailing Address - Phone:956-428-4258
Mailing Address - Fax:956-428-4292
Practice Address - Street 1:1622 N ED CAREY DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8286
Practice Address - Country:US
Practice Address - Phone:956-428-4258
Practice Address - Fax:956-428-4292
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220468717Medicaid
TX220468719Medicaid
TX0035AWOtherMEDICARE GROUP PTAN
TX220468718Medicaid
TX220468720Medicaid
TX220468718Medicaid