Individual
BERNARDINO OCTAVIO ELIZONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1389 WEST BUSINESS HWY 77, SUITE E, SAN BENITO, TX 78586
(956) 399-9929
(956) 399-4855
Mailing address
1389 WEST BUSINESS HWY 77, SUITE E, SAN BENITO, TX 78586
(956) 399-9929
(956) 399-4855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19338
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149837001
—
TX
Enumeration date
12/20/2005
Last updated
04/28/2010
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