Provider Demographics
NPI:1871283820
Name:UGAS, ANNELY CAMACHO
Entity type:Individual
Prefix:
First Name:ANNELY
Middle Name:CAMACHO
Last Name:UGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 GUYLER LN
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-7635
Mailing Address - Country:US
Mailing Address - Phone:830-765-6694
Mailing Address - Fax:
Practice Address - Street 1:1317 ST CLAIRE BLVD STE A3
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6636
Practice Address - Country:US
Practice Address - Phone:956-581-4403
Practice Address - Fax:956-581-2242
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41920122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry