Provider Demographics
NPI:1245620970
Name:RA NEIRA GARAGATTI DENTAL DDS PLLC
Entity type:Organization
Organization Name:RA NEIRA GARAGATTI DENTAL DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-331-8133
Mailing Address - Street 1:1337 E PALMA VISTA DR STE D
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2055
Mailing Address - Country:US
Mailing Address - Phone:956-331-8133
Mailing Address - Fax:956-313-8134
Practice Address - Street 1:1337 E PALMA VISTA DR STE D
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-2055
Practice Address - Country:US
Practice Address - Phone:956-331-8133
Practice Address - Fax:956-313-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty