Provider Demographics
NPI:1003516410
Name:RANGEL JUAREZ, ERIKA SELINA (DDS)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:SELINA
Last Name:RANGEL JUAREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 ALAMO RANCH PKWY STE 122
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4395
Mailing Address - Country:US
Mailing Address - Phone:210-504-2953
Mailing Address - Fax:
Practice Address - Street 1:12007 ALAMO RANCH PKWY STE 122
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4395
Practice Address - Country:US
Practice Address - Phone:210-504-2953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX406141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice