Max Teja Dda PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

16797 Issued in TX

Legal business name

MAX TEJA DDA PA

Practice address

4331 College Hills Blvd
San Angelo, TX 76904-6919

Phone

(325) 223-2373

NPI assigned

Mar 15, 2013

Organization subpart

No

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

Authorized official

Name

Mehboob Teja, DDS

Title

Owner

Phone

(325) 223-2373

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447545600000",
    "number": "1699016691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 COLLEGE HILLS BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046919",
            "telephone_number": "325-223-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 COLLEGE HILLS BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046919",
            "telephone_number": "325-223-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX TEJA DDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2015-11-15",
        "status": "A",
        "authorized_official_last_name": "TEJA",
        "authorized_official_first_name": "MEHBOOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-223-2373",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "16797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randell Gene Matthews, ATC., LAT
• Stephanie Matthews, PT
• Susan Matthews, SLP
• Brynne Michelle Matula, PT
• Marcos Mavromaras, MD
• Kalton Ray May, LPC
• Dayna Mayer, SLP
• Raymond C Mays, MD
• Kayli Mazza, RBT
• Megan Bryce McAda

• Dental Clinic/Center in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.