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Individual
DR. OCTAVIO MEJIA JR.
Active
Individual
DR. OCTAVIO MEJIA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19615
TX
1223G0001X
General Practice Dentistry
Primary
19615
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142541505
—
TX
01
—
B19615
DELTAL DENTAL STATE GOVERMENT PROGRAMS
TX
Enumeration date
05/20/2008
Last updated
05/24/2021
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