Active NPI
Ricardo Jose De la Garza, DDS
- Pediatric Dentistry
- San Antonio, TX
National Provider Identifier
1750386868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 20537
- Practice address
- 9514 Potranco Rd.
San Antonio, TX 78251 - Phone
- (210) 680-8080
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 20537 | TX | Primary |
Addresses
Primary practice location
9514 Potranco Rd.
San Antonio, TX 78251
Mailing address
9514 Potranco Rd.
San Antonio, TX 78251
Phone (210) 680-8080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144754201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20537 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229644800000",
"number": "1750386868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9514 POTRANCO RD.",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78251",
"telephone_number": "210-680-8080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9514 POTRANCO RD.",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78251",
"telephone_number": "210-680-8080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA GARZA",
"first_name": "RICARDO",
"middle_name": "JOSE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2008-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "20537",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144754201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.