# FORUM 7TO7 PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871261248
- **Authorized official:** ANDREA CAROLINA VILLARREAL (CREDENTIALING MANAGER)
- **Authorized official phone:** (210) 495-2000

## Contact information

- **Practice address:** 14975 IH 35 N, STE.105, SELMA, TX 78154-3320
- **Practice address phone:** (210) 495-2000
- **Practice address fax:** (210) 495-2001
- **Mailing address:** PO BOX 461649, SAN ANTONIO, TX 78246-1649
- **Mailing address phone:** (210) 495-2000
- **Mailing address fax:** (210) 495-2001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/01/2021
- **Last updated:** 09/01/2021