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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