Provider Demographics
NPI:1528655396
Name:TORRES, GENOVEVA R (RDH)
Entity type:Individual
Prefix:
First Name:GENOVEVA
Middle Name:R
Last Name:TORRES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 MIDDLE CRK
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-3056
Mailing Address - Country:US
Mailing Address - Phone:512-300-4738
Mailing Address - Fax:
Practice Address - Street 1:730 W STASSNEY LN STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3032
Practice Address - Country:US
Practice Address - Phone:512-954-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14554124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist