Individual
AIYEVBEKPEN OMO-OKHUASUYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
432 S BIBB AVE STE 300, EAGLE PASS, TX 78852-5390
(409) 203-9562
Mailing address
9827 MARBACH CRST, SAN ANTONIO, TX 78245-4476
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
37989
TX
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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