Provider Demographics
NPI:1730840786
Name:DEHOYOS-LAZO, RAISHEL B (RDA, EFDA)
Entity type:Individual
Prefix:
First Name:RAISHEL
Middle Name:B
Last Name:DEHOYOS-LAZO
Suffix:
Gender:F
Credentials:RDA, EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-7718
Mailing Address - Country:US
Mailing Address - Phone:210-808-3735
Mailing Address - Fax:
Practice Address - Street 1:3145 GARDEN AVE
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7718
Practice Address - Country:US
Practice Address - Phone:210-808-3735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist