Individual provider Active NPI

Andres Noe De la Garza, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1124122593
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19755 Issued in TX
Practice address
8110 Windway
San Antonio, TX 78239-2433
Phone
(210) 657-0101
Fax
(210) 657-7214
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19755 TX Primary

Addresses

Primary practice location

8110 Windway
San Antonio, TX 78239-2433

Mailing address

8110 Windway
San Antonio, TX 78239-2433
Phone (210) 657-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150625002421 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799096152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19755TXMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124122593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 WINDWAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782392433",
            "telephone_number": "210-657-0101",
            "fax_number": "210-657-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 WINDWAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782392433",
            "telephone_number": "210-657-0101",
            "fax_number": "210-657-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA GARZA",
        "first_name": "ANDRES",
        "middle_name": "NOE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.