Provider Demographics
NPI:1770293086
Name:HIGGS FAMILY DENTAL,PLLC
Entity type:Organization
Organization Name:HIGGS FAMILY DENTAL,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:HIGGS-HARBULA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:409-925-3549
Mailing Address - Street 1:PO BOX 741
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-0741
Mailing Address - Country:US
Mailing Address - Phone:409-925-3549
Mailing Address - Fax:409-925-2931
Practice Address - Street 1:13125 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:TX
Practice Address - Zip Code:77510-7681
Practice Address - Country:US
Practice Address - Phone:409-925-3549
Practice Address - Fax:409-925-2931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1407100829OtherNPPES