Provider Demographics
NPI:1750584165
Name:MEGO, MIGUEL ELIAS (DDS, MS)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:ELIAS
Last Name:MEGO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 W. TRENTON RD.
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539
Mailing Address - Country:US
Mailing Address - Phone:956-928-0022
Mailing Address - Fax:956-928-0068
Practice Address - Street 1:2525 W. TRENTON RD.
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-928-0022
Practice Address - Fax:956-928-0068
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics