# J.M. MEDINA, D.M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medina Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457451536
- **Authorized official:** DR. JESUS M. MEDINA D.M.D. (PRESIDENT)
- **Authorized official phone:** (210) 695-1738

## Contact information

- **Practice address:** 11868 BANDERA RD, HELOTES, TX 78023-4132
- **Practice address phone:** (210) 695-1738
- **Practice address fax:** (210) 695-1736
- **Mailing address:** 11868 BANDERA RD, HELOTES, TX 78023-4132
- **Mailing address phone:** (210) 695-1738
- **Mailing address fax:** (210) 695-1736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 20136 | TX | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 08/22/2020