Provider Demographics
NPI:1982735361
Name:VIRELLA, ALEGRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEGRA
Middle Name:
Last Name:VIRELLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ALEGRA
Other - Middle Name:
Other - Last Name:MIDGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3313 E COBBLESTONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7416
Mailing Address - Country:US
Mailing Address - Phone:215-205-5516
Mailing Address - Fax:
Practice Address - Street 1:995 N DICK DOWLING ST
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-5219
Practice Address - Country:US
Practice Address - Phone:956-399-1889
Practice Address - Fax:956-399-1878
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246071223G0001X, 1223P0221X
PADS0367011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry