Tomas Alicea

Individual provider Active NPI General Practice Dentistry · Cedar Park, TX

NPI 1932259249 · NPPES record last updated Apr 2, 2008

Key facts

NPI
1932259249
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
23205 (TX)
Practice address
401 E Whitestone Blvd
Cedar Park, TX 78613-9051
Phone
(512) 260-3777
Fax
(512) 260-1238
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
23205TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Dental Center PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23205 TX Yes

Addresses

Primary practice location

401 E Whitestone Blvd
Cedar Park, TX 78613-9051

Mailing address

PO Box 201982
Austin, TX 78720-1982
Phone (512) 997-8614

Other providers in Cedar Park, TX

All providers in Cedar Park, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.