Organization
ORAL AND MAXILLOFACIAL SURGERY OF SOUTH TEXAS, P.A.
Active
Organization
ORAL AND MAXILLOFACIAL SURGERY OF SOUTH TEXAS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCISCO M PEREZ DMD, MSD (OWNER)
(956) 878-1222
Entity
Organization
Contact information
Practice address
4728 SOUTH JACKSON RD, EDINBURG, TX 78539
(956) 878-1222
(956) 878-1228
Mailing address
4728 S. JACKSON ROAD, EDINBURG, TX 78539-6199
(956) 878-1222
(956) 878-1228
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20137
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210859901
THSTEPS DENTAL MEDICAID
TX
01
—
210859902
CSHCN DENTAL MEDICAID
TX
01
—
210859903
TRADITIONAL MEDICAID
TX
01
—
210859904
THSTEPS MEDICAL MEDICAID
TX
01
—
210859905
CSHCN MEDICAL MEDICAID
TX
Enumeration date
09/28/2009
Last updated
07/26/2010
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